To link to the entire object, paste this link in email, IM or documentTo embed the entire object, paste this HTML in websiteTo link to this page, paste this link in email, IM or documentTo embed this page, paste this HTML in website

Special assistance guidance manual

Special assistance guidance manual 2009-2010

Arizona Department of Education
Tom Horne, Superintendent of Public Instruction
Special Assistance Guidance Manual 2
TABLE OF CONTENTS
Chapter 1 - Introduction Page(s)
 Special Assistance Overview 3-6
 Impact of Special Assistance on Programs 7-12
 Special Assistance Case Studies 13-16
 How to Apply 17
 Participation Requirements 17
Chapter 2 – Operating a Base Year
 Administrative Requirements 18
 Claiming 18-20
 Administrative Review 20
 Approval 20
Chapter 3 - Operating a Non - Base Year
 Provision 2 Administrative Requirements 21
 Provision 2 Reimbursement Claims 21-24
 Provision 3 Administrative Requirements 25
 Provision 3 Reimbursement Claims 25-28
 Administrative Review 28
 Extensions 28
 End of Cycle 29
Chapter 4 – Administrative Resources
 Special Assistance Application 31
 Free and Reduced Price Policy Statement 32-36
 Extension Application 37
 Provision 2 Checklist 38
 Provision 3 Checklist 39
 Edit Check Spreadsheet 40
 Provision 2 Claiming Percentage Spreadsheet 41
 Provision 3 Meal Claim Calculation Spreadsheet 42
Appendix
 Glossary of Terms 43-45
Special Assistance Guidance Manual 3
CHAPTER 1 – INTRODUCTION
Special Assistance Overview
Traditionally, schools annually distribute household meal applications to families of all enrolled
children and make determinations of eligibility for free and reduced-price meals under the
National School Lunch Program (NSLP) and School Breakfast Program (SBP). In addition, schools
must count the number of meals served by category (free, reduced-price, and paid) and claim
meals in these categories. In an effort to reduce paperwork and other administration costs at
the local level, Congress incorporated into Section 11(a)(1) of the Richard B. Russell National
School Lunch Act (42 USC 1759a) three alternative Provisions to the traditional requirements
for annual determination of eligibility for free and reduced-price school meals and daily meal
counts by type. These alternatives are commonly referred to as Provision 1, 2, and 3. However,
Arizona only allows participation in Provision 2 and 3.
Special Assistance Guidance Manual 4
CHAPTER 1 – INTRODUCTION
Provision 2
Provision 2 is an option that enables sponsor’s to provide free meals to all of their students
while reducing paperwork and administrative costs. Under Provision 2, all students receive free
meals, regardless of income, and sponsor’s collect applications for free and reduced-price
meals once every four years, at most. Also, sponsor’s do not have to track and record the
different categories of meals served for at least three out of every four years. Sponsors pay
the difference between the cost of serving meals at no charge to all students and the federal
reimbursement for the meals.
Provision 2 is a four year cycle that establishes a CLAIMING PERCENTAGE in your base year (1st
year) which is then used for the following three non-base years (2nd, 3rd, 4th). For example, if
you were to start Provision 2 in the 2009-2010 school year:
Year 1 (base year) Year 2 (non-base yr) Year 3 (non-base yr) Year 4 (non-base yr)
2009-2010 2010-2011 2011-2012 2012-2013
Each base year MUST start at the beginning of the school year. During the base year, standard
meal counting and claiming procedures would still need to be followed, however, SFA’s would
offer meals to all students at no cost. This needs to be done in order to determine the claiming
percentages from the students’ eligibility status. Since household applications are collected and
status is determined, a claiming percentage can be derived. The claiming percentages
represent the ratio of meals served in each category to the total reimbursable lunch and/or
breakfast meals served.
For example: There are a total of 1,000 meals served in a month. Since each meal is recorded
by category in the base year, the following percentages are obtained:
Eligibility
Category
Total Meals Served By
Eligibility Category
÷ Total Meals
Served
= Claiming
Percentage
Free 800 ÷ 1,000 = 80%
Reduced 100 ÷ 1,000 = 10%
Paid 100 ÷ 1,000 = 10%
Special Assistance Guidance Manual 5
CHAPTER 1 – INTRODUCTION
A claiming percentage is calculated for each month during the base year and would then be
used during the next three non-base years.
During approved years (non-base years) of the Provision 2 cycle, the advantages include:
 Exemption from administrative requirements associated with collection of
household applications (certification) and conducting verification
 Increased participation and reimbursement in the meal program
 Simplified counting at the point of service
 Simplified claiming alternative based on established claiming percentages
Disadvantages include:
 Difficulty obtaining household applications for certification in future base years
 Financial risk due to a loss of revenues from reduced-price and paid meals when
operating a pricing program
Provision 3
Under Provision 3, the amount of reimbursement paid for the base year is paid during the next
4 years. This amount is adjusted annually for enrollment and inflation. The daily number of total
meals served must be recorded so that meal participation levels are monitored.
Provision 3 is a five year cycle that establishes an AMOUNT OF REIMBURSEMENT in the base
year (1st year) and that amount is used for the following four non-base years (2nd – 5th). For
example if you were to start Provision 3 in the 2009-2010 school year the cycle would be:
Year 1
(base year)
Year 2
(non-base yr)
Year 3
(non-base yr)
Year 4
(non-base yr)
Year 5
(non-base yr)
2009-2010 2010-2011 2011-2012 2012-2013 2013-2014
Special Assistance Guidance Manual 6
CHAPTER 1 – INTRODUCTION
The base year MUST start at the beginning of the school year. During the base year, standard
meal counting and claiming procedures would be followed; however, schools can choose to
operate a non-pricing or pricing program. Schools are encouraged to offer all meals at no cost
to have optimal participation and develop a level of reimbursement that may be more
reflective of participation during the base year. The amount of reimbursement that the school
receives in the first year is the amount that they will receive throughout the following four non-base
years. However, there is a monthly adjustment based on enrollment, number of serving
days, and inflation that may affect reimbursement.
During approved years (non-base years) of the Provision 3 cycle, the advantages include:
 Exemption from administrative requirements associated with collection of
household applications (certification) and conducting verification
 Simplified counting at the point of service
 Simplified claiming alternative based on base year reimbursement
Disadvantages include:
 Difficulty obtaining household applications for certification in future base years
 Financial risk due to a loss of revenues from reduced-price and paid meals when
operating a pricing program
Provision 2 and 3 - Breakfast Only Option
The Breakfast Only option allows sponsors to participate in a non-pricing program during
breakfast and to take advantage of simplified counting procedures at breakfast. This option is a
good alternative for sponsors seeking to expand their breakfast participation.
During approved years (non-base years) of the Breakfast Only option, the advantages include:
 Simplified counting at the point of service
 Simplified claiming alternative based on established claiming percentages (provision
2) or enrollment adjusted meals (provision3) for breakfast only
 Increased participation and reimbursement in the breakfast program
*Sponsors participating in the Breakfast Only option are still required to complete certification, verification, and
normal counting/claiming for lunch.
Special Assistance Guidance Manual 7
CHAPTER 1 – INTRODUCTION
Summary of Provision 2 and 3
Impact of Special Assistance
Operating under a non-pricing program can increase participation and therefore, positively
impact students in a number of ways. Studies demonstrate that students who participate in the
NSLP and SBP improve:
 School attendance
 Student behavior
 Test scores
While the benefits that the program has on students are well known, it is important to
understand the financial impact of operating under Special Assistance. In general, SFA’s that
understand and excel in the following areas have success financially.
 Certification/Verification Process
o District wide outreach to encourage parents to complete household applications
o Competent, well trained, and organized determining official
o Utilization of a well trained confirming official
o Utilization of Direct Certification throughout the school year
o Maintenance of an accurate benefit issuance document (meal count roster)
 Counting/Claiming Process
o Point of Service located at the end of the line and that matches/verifies a
student’s reimbursable meal to the benefits issuance document
o Accurately consolidating and verifying meal counts
Provision 2 Provision 3
Length of cycle Every 4 years Every 5 years
Length of cycle on extension 4 years 4 years
Base year meal type Non pricing Non pricing or standard pricing
Reimbursement type Claiming Percentage Amount of reimbursement
Enrollment/Serving Day adjustments No Yes
Option of Delayed Implementation Yes No
Special Assistance Guidance Manual 8
CHAPTER 1 – INTRODUCTION
*The Certification/Verification and Counting/Claiming processes directly determine the amount of
reimbursement that will be received during non-base years. Investing in the staff to execute these processes
during the base year will result in increased revenue during the non-base years.
 Menu Planning/Process Controls
o Offering a nutritious, well balanced menu that students enjoy will help maximize
student participation
o Execution of well planned cycle menus that utilize established process controls
such as: product specifications/order guides, standardized recipes, and correct
use of production records.
*How effectively a menu is planned/executed impacts the financial success of all food service programs.
 Labor
o Re-distribution/reduction of labor in non-base years to offset reduced
administrative duties associated with certification, verification, and
counting/claiming in base years.
*Labor re-distribution/reduction is one of the key cost savings (during non-base years) associated with operating
Special Assistance.
Financial Analysis
To determine the amount of labor and other savings throughout the school year, consider the
following:
1. How many labor hours are spent on processing household applications?
a. Preparing applications to be sent out
i. Include all sites
b. Initial collection of applications
c. Certifying eligibility status
d. Conducting direct certification and verification
e. Continuously collecting, updating and organizing applications
2. How many labor hours are used at the point of service?
a. Counting each student by eligibility status
b. Entering counts into a Point of Sale (POS) system
3. How much do supplies cost?
a. Printing
b. Distributing (postage etc.)
4. Other costs associated with traditional NSLP?
a. Hardware and technical support costs for POS system
Special Assistance Guidance Manual 9
CHAPTER 1 – INTRODUCTION
If food service costs are greater than federal reimbursement, other non-federal funds must
make up the difference.
To gain a better understanding of how your current program may be impacted by participating
in Special Assistance you can use the following Special Assistance Financial Analysis Tool.
Financial Analysis Tool Instructions
You can access the Special Assistance Financial Analysis Tool at the following website:
www.ade.az.gov/health-safety/cnp/sa/.
From the website, click Financial Analysis, and then click . This displays the
Excel spreadsheet on your screen and you can begin entering your information. When finished,
be sure to save the spreadsheet.
You must have Microsoft Excel version 97 or higher on your computer to use this tool. Follow
the onscreen directions to enter your information in the spaces provided.
You may not see the colored boxes on these pages, but you will see them on the website. A
green cell indicates a place for you to enter information. A blue cell indicates a place where the
spreadsheet displays calculations from the numbers you entered. A red triangle ( ) in the corner
of a cell indicates an attached comment that you can view in Excel.
Section A: Annual Revenue from Meals Served
1. Enter your school name in the space provided.
2. Enter the number of serving days in this school year.
3. For Sections 3, 4, and 5 enter data from your most recently completed month. For example, if today
is February 5, use data from January. You will use the numbers entered in this section to estimate
your increased participation in Part 3.
4. Enter the meal counts for the most recently completed month. Unless you are a single site school
district, this information does not come from the claim form but from a worksheet used to compile
the figures for the claim form.
Special Assistance Guidance Manual 10
CHAPTER 1 – INTRODUCTION
5. Enter the total amount of a la carte sales for the month you are using. Estimate the total food cost
of all a la carte items. You want the gross profit from these sales.
6. For sections 6 and 7, the spreadsheet calculates the total average daily revenue and the annual
revenue for meals served to students.
Section B: Annual Cost of Meals Served to Students
For Sections 1, 2, and 3 enter your data for the most recently completed fiscal year. You may
have to estimate the food cost for a single breakfast and a single lunch.
1. Enter the average cost per meal in each space.
2. Enter the annual cost of labor for your school.
3. Enter the cost per meal for non-food supplies.
Special Assistance Guidance Manual 11
CHAPTER 1 – INTRODUCTION
4. Enter the amount your school has decided will not be collectible.
5. The spreadsheet calculates this information for you.
Section C. Estimates for Provision 2 and 3
From Section A3, you have your current level of participation.
1. Now estimate what you think your increased level of participation will be. The participation should
be higher due to the non-pricing operation. The system calculates this information for you.
2. Enter the estimated decrease in labor costs. Using Special Assistance eliminates certain tasks, such
as application collection and meal counts by category. This should help to decrease your labor
expenses.
3. Estimate your decrease in a la carte sales and your estimated savings on cost of computerized meal
count system. The system, using your information, calculates the write offs and net estimate.
Special Assistance Guidance Manual 12
CHAPTER 1 – INTRODUCTION
Section D. Balance if Provision 2 or 3 is adopted.
Special Assistance Guidance Manual 13
CHAPTER 1 – INTRODUCTION
Special Assistance Case Studies
Inner City District
Number of Schools 20 Schools (16 = K-8, 2 = K-4, 2 = 6-8)
Total Enrollment ~ 11,000
Free and Reduced Percentage Range 72% - 97%
Background
This district is located in downtown Phoenix. The free and reduced percentage ranges between
72% and 97% between the 20 schools. Participation is high at approximately 85% for lunch and
moderately high at approximately 40% for breakfast. Enrollment has dropped some with new
charter schools opening in the attendance area.
Assessment
Special Assistance would be a good fit for this district because of the very high free and reduced
percentages, high participation and minimal drop in enrollment.
Decision
The district chose to implement Provision 3 due to the stable enrollment and to realize savings
by lowering labor costs associated with certification, verification, and counting/claiming duties.
Special Assistance Guidance Manual 14
CHAPTER 1 – INTRODUCTION
Reservation District
Number of Schools 1 School (K-8)
Total Enrollment ~ 180
Free and Reduced Percentage Range 96%
Background
This small school (also the district) is located on the Navajo Indian reservation in Northern
Arizona. The school is isolated and has a very high free and reduced percentage. The school
lunch and breakfast program is non-pricing.
Assessment
Because the school is non-pricing and enrollment is very steady, they are an ideal candidate for
Special Assistance, particularly Provision 3. There should not be a revenue loss because
students will not have any co-pays for lunch or breakfast. This school passed their latest
Coordinated Review Effort (CRE) and all proper administrative systems are in place.
Decision
The district chose to implement Provision 3 due to the static enrollment and to realize savings
in decreased labor costs associated with certification, verification, and counting/claiming
duties.
Special Assistance Guidance Manual 15
CHAPTER 1 – INTRODUCTION
Small Rural District
Number of Schools 3 Schools(1 = K-5, 1= 6-8, 1= 9-12)
Total Enrollment ~ 820
Free and Reduced Percentage Range 68% district wide (75% elementary)
Background
This small district is located in rural Arizona. The primary industry for the community is
agriculture and enrollment has been steady for several years. Even though the high school is an
open campus, there are very few competing lunch locations (i.e. McDonalds, Taco Bell, etc.)
Participation at the elementary school, among all categories (free, reduced and paid) is very
high, especially at lunch.
Assessment
This district currently collects in cash/checks $61,000 annually, from paid and reduced price
eligible students. Under Provision 2 or 3 this revenue would be forfeited, however the district
can realize certain savings in labor. The District estimates that it will save a half hour each day
by not performing categorized meal counts. In addition, five weeks each year (200 hrs.) will be
saved in labor by not collecting applications or performing verification. Unfortunately, the
difference between lost revenue and potential savings is still a negative $12,000. The District
would be required to subsidize any loss in the foodservice program.
Decision
The District chose not to implement Provision 2 or 3 because of the negative financial impact
on the Food Service department.
Special Assistance Guidance Manual 16
CHAPTER 1 – INTRODUCTION
Breakfast Only District
Number of Schools 13 Schools(7 = K-5, 4= 6-8, 2= 9-12)
Total Enrollment ~ 2900
Free and Reduced Percentage Range 70% – 75% at two elementary schools
Background
This district in Maricopa County is interested in implementing Special Assistance at the two
elementary school sites with the highest percentage of free and reduced eligible students. The
free and reduced percentage at the two schools is between 70-75%. The Superintendent asked
his business manager to prepare a financial statement to help determine what the financial
impact would be if the SFA participated in Special Assistance at breakfast and lunch.
Assessment
Because the two schools are less than 75% of free and reduced eligible students, implementing
Special Assistance will cause a significant revenue loss to the overall program. However, the
Superintendent is still interested in how the food service finances would be affected by
implementing Special Assistance for breakfast only.
It was determined that there would be a loss of approximately $2,000 if a non-pricing breakfast
was implemented; however, if there was a slight increase in participation among the free and
reduced students, it has the potential to offset the loss.
Decision
The sponsor decided to implement Provision 2 – Breakfast only because the increased student
participation would offset the revenue loss. The decision was based on the overwhelming
evidence that students learn better when they eat breakfast.
Special Assistance Guidance Manual 17
CHAPTER 1 – INTRODUCTION
How to Apply
Any sponsor who has participated in the NSLP for two years may apply to participate in the
Special Assistance program beginning their third year on the NSLP program year. New sponsors
must submit an original signed copy of the Special Assistance application no later than May 1st.
The Special Assistance application can be found at the following website:
www.ade.az.gov/health-safety/cnp/sa/
Participation Requirements
Once a completed application is received, the Arizona Department of Education (ADE) will
verify that the sponsor has participated in the NSLP for a minimum of two years. ADE will notify
the sponsor (by memo, no later than May 15th) of the requirements for entering a base year.
The base year requirements include the following:
 Submit a completed signed original copy of the Free and Reduced-Price policy statement
prior to the first day of school
 Distribute household applications, parent letters, and media release prior to the first
day of school
 Attend A+ School Lunch workshops (Day 1) and Provision 2 & 3 training prior to the first
day of school
*Failure to meet the above requirements by the first day of school will result in a denial of the request to
participate in Special Assistance. All sponsors who do not meet requirements may re-apply to participate
beginning the following school year.
To see training dates/times and to register please visit www.ade.az.gov/onlineregistration
Special Assistance Guidance Manual 18
CHAPTER 2 – OPERATING A BASE YEAR
Administrative Requirements
Once approved to enter in to a base year, the sponsor will operate the program under normal
NSLP operating conditions. This includes, but is not limited to, the following Key Administrative
Areas:
 Distribution, collection, and certification of school year household applications in
accordance with program guidelines
 Completion of Direct Certification within the first thirty operating days of the school
year
 Completion of the verification process and reporting in accordance with program
guidelines
 Counting/claiming of meals based on benefits issued during the certification process for
the entire school year
 Provision 2 sponsors must operate a non-pricing program
*Please remember that the benefits of the Special Assistance Program are not realized during the base year. The
program must operate in accordance with all NSLP program guidelines.
Base Year Reimbursement Claims
Standard claiming procedures (in accordance with NSLP guidelines) are used. Meals must be
counted at the point of service by eligibility category (free, reduced price, and paid) and
consolidated for each category for the monthly claims. All claims will continue to be processed
in CNP Web. See below for an example of the claim screen entry during base years.
Special Assistance Guidance Manual 19
CHAPTER 2 – OPERATING A BASE YEAR
Sample Base Year Claim – April 2009
If more than one site will be participating, each school must have their own eligibility data.
Also, breakfast, lunch, and snack counts must remain separate. The CNP web system will use
your monthly base year claims to automatically calculate claims in non-base years.
Regular Claim Entry
 Number of Days Served
 Meals by Eligibility Category
 Participants Approved by Category
 Participants Enrolled
Special Assistance Guidance Manual 20
CHAPTER 2 – OPERATING A BASE YEAR
* The data submitted in these base year claims can be used to show free and reduced percentages by month
(verification exempt reporting, e-rate audits, grants, etc.) as needed.
Claiming Requirements
Claims must be processed for each month in which program meals are served. Sponsors
conducting a base year following the end a previously approved provision cycle (breakfast and
lunch) are not eligible for the 30-day eligibility rollover to start the school year. Provision status
offers a claiming alternative to individual sites and therefore no eligibility can be assigned to
individual students. These students automatically default to a paid status when the initial
certification process begins.
Administrative Review
During the base year, the ADE will conduct an administrative review to verify compliance with
NSLP regulations. The administrative review may be conducted as one of the following:
 Coordinated Review Effort (CRE) – regularly scheduled review
 CRE Follow-Up – regularly scheduled review to follow-up on previous year’s CRE
 Abbreviated Review – an additional administrative review conducted outside of the
regular CRE schedule
ADE will review compliance in the following key Administrative Areas:
 Certification
 Counting/Claiming
 Verification
A final determination will be made to certify the base year for the Sponsor’s entrance into the
Special Assistance program. Sponsors that do not meet regulations during their administrative
review will be sent a Special Assistance Unsatisfactory Base Year memo. Sponsors with an
Unsatisfactory Base Year may re-apply to participate in the program the following year.
Approval
Sponsors that successfully complete a base year will receive a Special Assistance Certification
Memo that outlines the approved Provision 2 or 3 cycle and describe the requirements during
the non-base years. The Certification Memo should be retained by the sponsor to document
the approved Provision 2 or 3 cycle.
Special Assistance Guidance Manual 21
CHAPTER 3 – OPERATING A NON-BASE YEAR
Provision 2 Administrative Requirements
Breakfast and Lunch
Once the base year is approved the sponsor will be able to operate under Provision 2 status for
a period of three years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast and lunch program for each non-base year
 Maintain all base year records for a period of five years after the completion of the
approved provision cycle
 Attend Provision 2 and 3 training during each non-base year
 Submit the Verification exempt report prior to March 1st of each school year
During the approved non base years, the approved sites are considered exempt from
Certification and Verification and may NOT complete the following:
 Distribute and/or collect household applications
 Conduct Direct Certification (unless approved as part of an extension application)
*Distribution of household applications and/or conducting direct certification (at approved sites) during a non-base
year will result in forfeiture of Special Assistance status.
Breakfast Only
Once the base year is approved, the sponsor will be able to operate under Provision 2 status for
a period of three years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast program for each non-base year
 Attend Provision 2 and 3 training or A+ School Lunch Workshop (Day One) during each
non-base year
Provision 2 Reimbursement Claims
Breakfast and Lunch
At the completion of the base year, the established monthly claiming percentages are used to
calculate non-base year claims. The school will still continue to use CNP Web to enter claims.
However, only the total number of meals served and serving days for the claim month will be
entered in CNP web. The computer will calculate the number of reimbursable meals per
category by multiplying the total meals served by the established claiming percentage.
Special Assistance Guidance Manual 22
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 2 Claim (Breakfast and Lunch) – April 2009
During the non-base years the total amount of meals served will be reimbursed according to
the claiming percentage. The established claiming percentages (April of base year) in the above
situation were as follows:
Provision 2 (Breakfast/Lunch) Claim Entry
 Number of Days Served
 Total Meals Served
 Participants Enrolled
CNP Web Calculates
 Meals Served by Category
Special Assistance Guidance Manual 23
CHAPTER 3 – OPERATING A NON-BASE YEAR
Breakfast
BY Claiming Percentage x Total Meals Served = Adjusted Reimbursable Meals
62.64% Free x 6960 = 4360
11.18% Reduced x 6960 = 778
26.18% Paid x 6960 = 1822
Lunch
BY Claiming Percentage x Total Meals Served = Adjusted Reimbursable Meals
69.70% Free x 13659 = 9520
10.72% Reduced x 13659 = 1465
19.57% Paid x 13659 = 2674
Breakfast Only
At the completion of the base year, the established monthly claiming percentages are used to
calculate claims for breakfast only. The computer will calculate the number of reimbursable
breakfast meals per category by multiplying the total meals served by the established claiming
percentage. The regular claiming process by eligibility category still occurs for lunch.
Special Assistance Guidance Manual 24
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 2 Claim (Breakfast Only) – April 2009
Claiming percentages for breakfast are calculated in the same manner as described in the
previous example.
Provision 2 (Breakfast) Claim Entry
 Number of Days Served
 Total Meals Served
 Participants Enrolled
CNP Web Calculates
 Meals Served by Category
Regular Lunch Claim Entry
 Number of Days Served
 Meals by Eligibility Category
 Participants Approved by Category
 Participants Enrolled
Special Assistance Guidance Manual 25
CHAPTER 3 – OPERATING A NON-BASE YEAR
Provision 3 Administrative Requirements
Breakfast and Lunch
Once the base year is approved, the sponsor will be able to operate under Provision 3 status for
a period of four years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast and lunch program for each non-base year
 Maintain all base-year records for a period of five years after the completion of the
approved provision cycle
 Attend Provision 2 and 3 training during each non-base year
 Submit the Verification exempt report prior to March 1st of each school year
During the approved non-base years, the approved sites are considered exempt from
Certification and Verification and may NOT complete the following:
 Distribute and/or collect household applications
 Conduct Direct Certification (unless approved as part of an extension application)
*Distribution of household applications and/or conducting direct certification (at approved sites) during a non-base
year will result in forfeiture of Special Assistance status.
Provision 3 Reimbursement Claims
At the completion of the base year, the monthly amount of reimbursement will be used to
calculate non-base year claims. The sponsor will still continue to use CNP Web to enter in
claims. However, only the total number of meals served, the current enrollment as of the end
of the month, and the number of serving days will be entered. The computer will calculate the
number of reimbursable meals per category based on the enrollment and serving day changes.
The calculated total meals are multiplied by the current reimbursement rates to determine the
total amount of reimbursement.
Special Assistance Guidance Manual 26
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 3 Claim – May 2009
During the non-base years the percent change in enrollment, enrollment adjusted meals by
category, and serving day adjustments are used to calculate the total reimbursement.
Provision 3 Claim Entry
 Number of Days Served
 Participants Enrolled
 Total Meals Served
Special Assistance Guidance Manual 27
CHAPTER 3 – OPERATING A NON-BASE YEAR
Lunch Example
Percent Change Enrollment
Current Enrollment ÷ Base Year Enrollment = Enrollment Change
328 ÷ 365 = .8986
Enrollment Adjusted Meals
Base Year Meals x Enrollment Change = Enrollment Adjusted Meals
3827 (Free) x .8986 = 3439
1521 (Reduced) x .8986 = 1367
1509 (Paid) x .8986 = 1356
Serving Day Adjusted Meals
Enrollment Adjusted
Meals
÷ Base Year
Serving Days
x Current Year
Serving Days
= Serving Day Adjusted
Meals
3439 (Free) ÷ 23 x 14 = 2093
1367 (Reduced) ÷ 23 x 14 = 832
1356 (Paid) ÷ 23 x 14 = 825
The serving day adjusted meals are multiplied by the current year reimbursement rates to
determine the total reimbursement. The same calculations are completed for breakfast and
lunch.
Breakfast Only
At the completion of the base year, enrollment and serving day adjusted meals are used to
calculate claims for breakfast only. The serving day adjusted meals are multiplied by the
current year reimbursement rates to determine the total reimbursement. The regular claiming
process by eligibility category still occurs for lunch.
Special Assistance Guidance Manual 28
CHAPTER 3 – OPERATING A NON-BASE YEAR
Administrative Review
During non-base years ADE will conduct regularly scheduled CRE reviews. The CRE will include
an audit of base year records.
Extension
An extension allows the sponsor to continue Provision 2 or 3 for a new four year cycle. As a
result the school can serve meals at no cost for another four years without having to complete
a new base year. Sponsors must notify ADE by submitting and Application for Extension by May
1st of the 2nd non-base year. The Special Assistance Extension application can be found at the
following website:
www.ade.az.gov/health-safety/cnp/sa/
ADE will provide guidance on approved data that may be submitted based on information from
the extension application. All socio-economic data must meet the following criteria:
 Be reflective of the school’s population
 Be equivalent data for both the base year and the last year of the cycle
 Effectively measure whether the income level of the school’s population (adjusted for
inflation) has remained stable, declined or had only negligible improvement
Provided that the above criteria are met, pre-approved socio-economic data includes:
 Direct Certification results from the participating school/district
 Local Unemployment data
 Local Supplemental Nutrition Assistance Program (SNAP – formerly Food Stamp
Program)
 Food Distribution Program on Indian Reservation (FDPIR) results
 Temporary Assistance for Needy Families (TANF)
 Information collected by the city or county zoning and economic planning office
To obtain an extension the school must provide approved socio-economic data no later than
March 1st of the last non-base year. The approved socio-economic data will be evaluated by
ADE to ensure that the data does not exceed a five percent threshold level. Sponsors are
encouraged to submit approved data as early as possible during the last non-base year so that it
may be evaluated. ADE will notify sponsors of their extension status no later than May 15th.
Special Assistance Guidance Manual 29
CHAPTER 3 – OPERATING A NON-BASE YEAR
End of Cycle
All sponsors should refer to their initial Special Assistance Certification Memo to determine
when their approved cycle will end. As a courtesy, ADE will notify sponsors by memo that their
approved cycle has ended. The following options are available to sponsors at the end of the
cycle:
 Re-apply for the Special Assistance program by submitting a Special Assistance
Application
 Revert back to standard meal counting and claiming procedures
Special Assistance Guidance Manual 30
CHAPTER 4 – ADMINISTRATIVE RESOURCES
The following pages include resources for the Special Assistance program. Printable copies and
downloadable spreadsheets can be found on the Special Assistance website located at:
www.ade.az.gov/health-safety/cnp/sa/
 Special Assistance Application
 Free and Reduced Price Policy Statement
 Extension Application
 Base Year Checklist
 Non-Base Year Checklist
 Edit Check Spreadsheet
 Provision 2 Claiming Percentage Spreadsheet
 Provision 3 Claim Spreadsheet
Special Assistance Guidance Manual 31
Arizona Department of Education
Child Nutrition Program
Special Assistance Application
Please review the Special Assistance Guidance Manual. After reviewing the manual, if you would like to apply for the Special Assistance
Program, please complete this application. Once completed, submit the application to the Special Assistance coordinator at the Arizona
Department of Education, Child Nutrition Programs for review. Please note that this application is not approved until you receive an official
letter of approval from this department.
Sponsor Name: CTD#
Contact/Title: Phone #:
1. Indicate the Special Assistance provision that will be operated: Provision 2 or Provision 3
2. Indicate the number of sites that will be participating in the Special Assistance Program: _____________
Please attach on School District Letterhead a list of all sites. Please indicate the fields listed below.
NAME OF SCHOOL BASE YEAR BREAKFAST (B), LUNCH (L), OR BOTH (BL)
3. During the base year each sponsor must demonstrate compliance with all certification, counting/claiming, and verification procedures during
an administrative review. Is this requirement understood? Y____ N____
4. A sponsor may not supplement its meal service operation with any federal funds other than USDA reimbursement, BIA funds and any other
source earmarked for meal service. Is this requirement understood? Y____ N____
5. A qualified representative is required to attend the A+ School Lunch Workshop and Provision 2 & 3 training prior to the first operating day of
the base year and Provision 2 and 3 training in each non-base year. Is this requirement understood? Y____ N____
6. Have you read and understood the requirements of Special Assistance (see Special Assistance guidance manual)? Y____ N ____
I CERTIFY that the information in this application is true, and that I agree to carry out the terms of the agreement to operate the Special
Assistance Program. I understand that this information is given in connection with the receipt of federal funds and that deliberate
misinterpretation may be subject to prosecution under applicable federal statutes.
Print name (authorized signatory): ___________________________________________________________
Signature: _______________________________________________________________________________ Date: _________
________________FOR OFFICE USE ONLY______________
Date of Last Review: ____________________________ Passed: Y____N____
Approved: Y___ N____ Original Base Year: ____________________ Provision: ____
Approved By: ________________________ _____________________________________________ Date: _________
Additional Information/Comments:
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Base Year: ______ Extension Request Due: Next Base Year:
Special Assistance Guidance Manual 32
Free and Reduced Price Policy Statement
Policy Statement for Pricing Programs
This policy statement outlines regulations of the United States Department of Agriculture and will be
considered a permanent document. This statement applies to the programs in which the sponsor will be
participating as indicated on the application and agreement.
The SPONSOR assures the STATE AGENCY that the SPONSOR will implement a policy in
conformance with 7 CFR part 245.10 to determine children’s eligibility for free and reduced-price
benefits (meals and/or milk) in the National School Lunch, School Breakfast and Special Milk Programs
under its jurisdiction. In fulfilling its responsibilities, the SPONSOR shall:
1. Provide prescribed benefits free or at a reduced-price to children from families whose income
does not exceed DEPARTMENT guidelines or to children from food stamp households, Cash
Assistance (CA) or Food Distribution Program on Indian Reservations (FDPIR) assistance units
that provide a case number or are directly certified by the Department of Economic Security.
NOTE: The SPONSOR has two options if participating in the Special Milk Program: 1) to offer
milk free, or 2) to charge for milk, on a nonprofit basis.
2. Submit annually to the STATE AGENCY, Child Nutrition Programs Unit, copies of the
SPONSOR’S Parent Letter (including names of the reviewing officials and hearing official),
Income Application, Approval/Denial Notice, Meal Count System Information, the Free and
Reduced-Price Document Summary and After School Care Program Information, if the
SPONSOR is new to the program or if there have been changes to the previously approved forms.
3. If there have been no changes, submit the Free and Reduced-Price Document Summary and
indicate the options you have selected for the new program year. The Income Application,
Approval/Denial Notice and Meal Count System Information shall be deemed part of this policy
statement and will be made permanent. Changes to any of the above documents require the
approval of the STATE AGENCY, Child Nutrition Programs Unit.
4. Accept applications at any time during the year. If a child transfers from one school to another,
under the jurisdiction of the same SPONSOR, eligibility for free or reduced-price benefits will be
transferred to and honored by the receiving school. All children from a family which receives the
same benefits shall be notified within ten working days of the acceptance or denial of their
application. Children shall be served immediately upon the establishment of their eligibility.
5. When an application is rejected, parents or guardians shall be informed in writing of the reason
for denial and of the hearing procedures herein provided. Parents shall be notified that they may
reapply for free and reduced-price benefits or free milk at any time during the school year. The
SPONSOR shall designate as a hearing official someone not involved in the original eligibility
determination, preferably someone in a position superior to that of the determining official.
6. Establish a hearing procedure under which: (1) a family may appeal a decision made by the
School Food Authority with respect to an application the family has made for free or reduced-price
meals or for free milk, and (2) the School Food Authority may challenge the continued
eligibility of any child for a free or reduced-price meal or for free milk. The hearing procedure
shall provide for both the family and the School Food Authority:
Special Assistance Guidance Manual 33
a. A simple, publicly announced method to make an oral or written request for a hearing;
b. An opportunity to be assisted or represented by an attorney or other person;
c. An opportunity to examine, prior to and during the hearing, any documents and records
presented to support the decision under appeal;
d. Assurance that the hearing shall be held with reasonable promptness and convenience,
and that adequate notice shall be given as to the time and place of the hearing;
e. An opportunity to present oral or documentary evidence and arguments supporting a
position without undue interference;
f. An opportunity to question or refute any testimony or other evidence and to confront and
cross-examine any adverse witnesses;
g. Assurance that the hearing shall be conducted and the decision made by a hearing official
who did not participate in making the decision under appeal or in any previously held
conference;
h. Assurance that the decision of the hearing official shall be based on the oral and
documentary evidence presented at the hearing and made a part of the hearing record;
i. Assurance that the parties concerned and any designated representative shall be notified
in writing of the decision of the hearing official;
j. Assurance that a written record shall be prepared with respect to each hearing, which
shall include the challenge or the decision under appeal, any documentary evidence and a
summary of any oral testimony presented at the hearing, the decision of the hearing
official, including the reasons therefore, and a copy of the notification to the parties
concerned of the decision of the hearing official;
k. Assurance that the written record of each hearing shall be preserved for a period of five
years and shall be available for examination by the parties concerned or their
representatives at any reasonable time and place during that period;
l. Notice that benefits already ongoing shall be continued until ten working days after a
decision has been reached by the hearing official;
m. Notice that households that have been approved for benefits and that are subject to a
reduction or termination of benefits later in the same school year shall receive continued
benefits if they appeal the adverse action within the 10-calendar-day advance notice
period; and
n. Notice that households that are denied benefits upon application shall not receive
benefits.
7. Not segregate or discriminate against any child because of inability to pay the full price. Further
assurance is given that:
Special Assistance Guidance Manual 34
a. The names of the children shall not be published, posted, or announced in any manner,
unless an approved multi-use application is in use;
b. There shall be no overt identification of any of the children by the use of special tokens,
tickets, or by any other means. The children shall not be required to work for their meals
or milk;
c. The children shall not be required to use a separate dining area, go through a separate
serving line, enter the dining area, or consume their meals or milk at a different time;
d. When more than one lunch, breakfast, or type of milk is offered which meets the
requirements of 7 CFR parts 210.10, 220.8 or 215.2, the children shall have the same
choice of meals and/or milk that is available to those children who pay the full price for
their meals and/or milk; and
e. Children shall not be discriminated against because of race, color, national origin, gender,
religion, age, disability, political beliefs, sexual orientation and marital or family status.
8. Make determinations of eligibility for free or reduced-price benefits specified in 7 CFR part 245.
Officials shall use the criteria referred to in this policy for the household application.
9. Distribute to each child’s parent or guardian a letter announcing eligibility criteria as required in 7
CFR part 245.5(a) and an application form for free or reduced-price benefits at the beginning of
each school year and whenever there is a change in eligibility criteria.
10. Make available the free and reduced-price guidelines and other information contained in the
parent letter to local unemployment offices and major employers contemplating large layoffs in
the area from which its attendance is drawn as required in 7 CFR part 245.5(a).
11. Verify approved free and reduced-price applications by December 15 as specified by 7 CFR part
245.6a. Maintain a description of the verification activities as required by CFR part 245.6a 3(c).
12. Have the opportunity to determine children as eligible for free meals or free milk based on Direct
Certification in place of information submitted by the household on the household application.
Direct Certification forms must be retrievable by school.
13. Agree that the STATE AGENCY will submit a public/press release containing both free and
reduced-price eligibility guidelines and other information required to be contained in parent letter
to news media. The SPONSOR agrees to submit a public/press release to local unemployment
offices and major employers contemplating or experiencing layoffs.
Policy Statement for Non Pricing Programs (Check box of Provision that applies)
The SPONSOR warrants and represents that:
1. All children in attendance or residence are being served the same choice of meals and/or milk
at no separate charge.
2. The SPONSOR has data on all children claimed for free or reduced-price benefits and assures
the STATE AGENCY that each child receiving such benefits meets the prescribed eligibility
criteria.
Special Assistance Guidance Manual 35
3. A daily count is kept by meal type for all meals and/or milk claimed.
 Special Assistance - Provision 2 Programs, Additional Requirements if applicable
A School Food Authority which oversees a school serving meals free of charge to all enrolled children in
that school may publicly notify and certify children for free and reduced-price meals for up to four
consecutive school years, provided that eligibility determinations shall be in accordance with 7 CFR part
245.3 during the first school year. The following requirements shall apply:
1. Except for assistance properly made available under parts 210, 220, 240, 250, the Indian Child
Welfare Act 95-608, and by other legislation, a School Food Authority of a school operating under
Provision 2 requirements agree to pay with funds from other than federal sources for:
a. Meals served to children not eligible for free or reduced-price meals; and
b. The differential between the per-meal cost and federal reimbursement received for each free
or reduced-price meal, respectively, served to children eligible to receive such meals under
applicable program regulations.
2. In the first year (base year), schools must take daily counts each month of the number of meals served
by meal type (free, reduced-price, and paid) and convert the number of each meal type to a percentage
of total meals served for the month. The percentages are derived by dividing the monthly total
number of meals served by one meal type (e.g. free) by the total number of meals served the same
month for all meal types (free, reduced-price, and paid).
3. For the purpose of calculating reimbursement claims, for the second, third, and fourth school years,
the three percentages, calculated at the end of each month of the first school year (base year), shall be
multiplied by corresponding monthly meal totals of all meal types (free, reduced-price and paid
meals).
4. Eligibility determinations from the base year must be maintained for as many years as necessary to
substantiate claims for reimbursement in the applicable Provision 2 cycle, including any extensions of
that cycle. Extensions may be granted based on pre-approved socioeconomic data which includes:
Direct Certification results from the participating school/district, local unemployment data, local
Supplemental Nutrition Assistance Program data, Food Distribution Program on Indian Reservation
(FDPIR) results, Temporary Assistance for Needy Families (TANF) and information collected by the
city or county zoning and economic planning office.
 Special Assistance - Provision 3 Programs, Additional Requirements if applicable
A School Food Authority which oversees a school serving meals free of charge to all enrolled children
may publicly notify and certify children for free and reduced-price meals for up to five consecutive school
years, provided that eligibility determinations shall be in accordance with 7 CFR part 245.3 during the
first school year. The following requirements shall apply:
1. Except for assistance properly made available under parts 210, 220, 240, 250, the Indian Child
Welfare Act 95-608, and by other legislation, a School Food Authority of a school operating under
Provision 3 requirements agrees, after the first year, to pay with funds from other than federal sources
for:
Special Assistance Guidance Manual 36
a. Meals served to children not eligible for free or reduced-price meals; and
b. The differential between the per-meal cost and federal reimbursement received for each free
or reduced-price meal, respectively, served to children eligible to receive such meals under
applicable program regulations.
2. Reimbursement in the four years following the first year (base year) will be determined by taking the
prior year’s reimbursement and adjusting for changes in enrollment and inflation. Meal counts are
not required to be taken during these years. Enrollment change must be based on the school’s
enrollment on October 31 annually.
3. Eligibility determinations from the base year must be maintained for as many years as necessary to
substantiate claims for reimbursement in the applicable Provision 3 cycle, including any extensions of
that cycle. Extensions may be granted based on pre-approved socioeconomic data which includes:
Direct Certification results from the participating school/district, local unemployment data, local
Supplemental Nutrition Assistance Program data, Food Distribution Program on Indian Reservation
(FDPIR) results, Temporary Assistance for Needy Families (TANF) and information collected by the
city or county zoning and economic planning office.
_________________________________________ ________________________________
(Print or Type Name and Title) (Authorized Signature)
_________________________________________ ________________________________
(Sponsor/School) (Date)
Special Assistance Guidance Manual 37
Arizona Department of Education
Child Nutrition Program
Application for an Extension on Special Assistance
Please review the Special Assistance Guidance Manual. After reviewing the manual, if you would like to apply for an extension on Special
Assistance Program, please complete this application. Once completed, submit the application to the Special Assistance coordinator at the
Arizona Department of Education, Child Nutrition Programs for review. Please note that this application is not approved until you receive an
official letter of approval from this department.
Sponsor Name: CTD#
Contact/Title: Phone #:
1. Indicate the Special Assistance Provision (2 or 3) that is currently being operated: Provision 2 or Provision 3
2. Indicate the number of special assistance sites that are being operated: _____________
Please attach on School District Letterhead a list of all sites. Please indicate the fields listed below.
NAME OF SCHOOL BASE YEAR BREAKFAST (B), LUNCH (L), OR BOTH (BL)
3. Please indicate the approved socioeconomic data that will be submitted to the Arizona Department of Education. Data submitted must be
from the base year and the last non base year. All data must be submitted by March 1st of the last non-base year.
Socioeconomic Data Source BASE YEAR LAST NON-BASE YEAR
I CERTIFY that the information in this application is true, and that I agree to carry out the terms of the agreement to operate the Special
Assistance Program. I understand that this information is given in connection with the receipt of federal funds and that deliberate
misinterpretation may be subject to prosecution under applicable federal statutes.
Print name (authorized signatory) ___________________________________________________________
Signature: ______________________________________________________________________________ Date:_________
________________FOR OFFICE USE ONLY______________
Date of Last Review: ____________________________ Passed: Y____N____
Approved: Y___ N____ Original Base Year: ____________________ Provision: ____
Approved By: __________________________________________ Date: __________
Additional
Information/Comments:_________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Base Year: ______ Extension Request Due: Next Base Year:
Special Assistance Guidance Manual 38
Provision 2 Checklist
Applying
 Review the Special Assistance Guidance Manual
 Submit Special Assistance application no later than May 1st of school year prior to base year
 Submit and update Free and Reduced Price Policy Statement (check box for Provision 2)
 Attend A+ School Lunch Workshop (day one) prior to first day of school
 Attend Provision 2 and 3 training prior to first day of school
Base Year
 Distribute household applications to all families
 Send Non-Pricing letter to parents indicating ALL students may receive meals at NO cost
 Notify public that meals to ALL students will be served at NO cost
 Conduct Direct Certification, certify applications, conduct verification
 Accurately Count/Claim total number of reimbursable meals served at the point of service
by eligibility category
 Submit claims for each operational month during base year
 Indicate Special Assistance Base Year on CNP Web online applications
Non-Base Years 1 & 2
 Notify parents that meals will be provided to ALL students at no cost
 Count total number of reimbursable meals served at the point of service
 If requesting an extension, submit an application for extension no later than May 1st of the
2nd non-base year
 Attend Provision 2 and 3 training annually
Non-Base Year 3 (End of Cycle)
 Attend Provision 2 and 3 training
 If school will continue to operate under Special Assistance they must submit a Special
Assistance Application no later than May 1st
 If School has applied for an extension of Special Assistance
o Provide the Arizona Department of Education with specified socio-economic data no
later than March 1st
OR
 If School will no longer be operating under Provision 2 and will resort back to standard
operation
o Send notification letter to parents (at the end of the school year)
Special Assistance Guidance Manual 39
Provision 3 Checklist
Applying
 Review the Special Assistance Guidance Manual
 Submit Special Assistance application no later than May 1st of school year prior to base year
 Submit and update Free and Reduced Price Policy Statement (check box for Provision 3)
 Attend A+ School Lunch Workshop (day one) prior to first day of school
 Attend Provision 2 and 3 training prior to first day of school
Base Year
 Send household applications to all families
 Send Non-Pricing letter to parents indicating ALL students may receive meals at NO cost (if
applicable)
 Conduct Direct Certification, certify applications, conduct verification
 Accurately Count/Claim total number of reimbursable meals served at the point of service
by eligibility category
 Submit claims for each operational month during base year
 Indicate Special Assistance Base Year on CNP Web online applications
Non-Base Years 1, 2, & 3
 Notify parents that meals will be provided to ALL students at no cost
 Count total number of reimbursable meals served at the point of service
 If requesting an extension, submit an application for extension no later than May 1st of the
3rd non-base year
 Attend Provision 2 and 3 training annually
Non-Base Year 4 (End of Cycle)
 Attend Provision 2 and 3 training
 If sponsor has applied for an extension of Special Assistance
o Provide the Arizona Department of Education with specified socio-economic data no
later than March 1st
 If sponsor will continue to operate under Special Assistance they must submit a Special
Assistance Application no later than May 1st
OR
 If sponsor will no longer be operating under Provision 3 and will resort back to standard
operation
o Send notification letter to parents (at the end of the school year)
Special Assistance Guidance Manual
School Year
Free Total Free Total
1 0 0% 0 0%
2 0 0% 0 0%
3 0 0% 0 0%
4 0 0% 0 0%
5 0 0% 0 0%
6 0 0% 0 0%
7 0 0% 0 0%
8 0 0% 0 0%
9 0 0% 0 0%
10 0 0% 0 0%
11 0 0% 0 0%
12 0 0% 0 0%
13 0 0% 0 0%
14 0 0% 0 0%
15 0 0% 0 0%
16 0 0% 0 0%
17 0 0% 0 0%
18 0 0% 0 0%
19 0 0% 0 0%
20 0 0% 0 0%
21 0 0% 0 0%
22 0 0% 0 0%
23 0 0% 0 0%
24 0 0% 0 0%
25 0 0% 0 0%
26 0 0% 0 0%
27 0 0% 0 0%
28 0 0% 0 0%
29 0 0% 0 0%
30 0 0% 0 0%
31 0 0% 0 0%
Total 0 0 Total 0 0
Percent participation (Attendance Factor Adjusted) should not exceed 100% under normal circumstances and the total count should not exceed enrolled under any circumstances. Should this
percent exceed 100% please verify meal count accuracy. If no meal count errors are present please contact your program specialist regarding adjustment of established attendance factor.
Enrollment
Date
% Part.
Of Free
Daily Edit Check Worksheet
Attendance Factor =
Edit Check Calculation School Lunch Program Meals
% Part.
Of Free
Month
# # Lunches Served Pupils Breakfasts Served Pupils
Reimbursable Meals Reimbursable Meals
School Breakfast Program Meals
40
Special Assistance Guidance Manual
Provision 2 Base Year Claiming Percentage Calculator
Free Meals Served
= 0 Free Meals Served =
Reduced-Price Meals Served
= 0 Reduced-Price Meals Served =
Paid Meals Served
= 0 Paid Meals Served =
Total Meals Served
= 0 Total Meals Served =
Free Claiming Percentage
= 0.0000% Free Claiming Percentage = 0.0000%
Reduced Claiming Percentage
= 0.0000% Reduced Claiming Percentage = 0.0000%
Paid Claiming Percentage
= 0.0000% Paid Claiming Percentage = 0.0000%
School:
Month/Year:
Breakfast
Lunch
41
Special Assistance Guidance Manual
Provision 3 Lunch Meal Calculations
School:
Base Year Meals
Free = 0
Reduced-Price = 0
Paid = 0
Enrollment and Serving Days
Base Year Enrollment = 0
Base Year Serving Days = 0
Current Year Enrollment = 0
Current Year Serving Days = 0
Calculations
Total Meals = 0
Month: Year:
Percent Change Enrollment =
Current Year
Enrollment
/
Base Year
Enrollment
= 0 / 0 = 0.0000
Enrollment Adjusted Free Meals =
Base Year Free
Meals
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Enrollment Adjusted Reduced-
Price Meals
=
Base Year
Reduced -Price
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Enrollment Adjusted Paid Meals =
Base Year Free
Meals
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Serving Day Adjusted Free
Meals
=
Enrollment
Adjusted Free
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
Serving Day Adjusted Reduced-
Price Meals
=
Enrollment
Adjusted
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
Serving Day Adjusted Paid
Meals
=
Enrollment
Adjusted Paid
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
42
Special Assistance Guidance Manual 43
Appendix
Glossary of Terms
ADE Arizona Department of Education
Administrative Review Review conducted by Child Nutrition Program staff to
assess the adequacy of the eligibility certification process,
accuracy of the meal counting and claiming system, and
completion of the verification in the base year.
Annual Claiming Percentages
(Provision 2 only)
A school may add meal counts by category for the entire
base year and convert to claiming percentages for free,
reduced-price, and paid meals. The school then uses the
annual claiming percentage for each category for each
month of the non-base year.
Base Year The year that applications for free or reduced-price meal
benefits were distributed, eligibility determinations were
made, and verification was conducted. This is considered
the first year of operation for provisions.
Benefit Issuance Document Link between the eligibility determination and how a meal
is claimed for reimbursement. Must be completed during a
base year.
Child Nutrition Programs Includes the National School Lunch, School Breakfast,
Special Milk Programs, After School Care Snack Program,
and Summer Food Programs.
Daily Edit Checks Ensures the number of eligible children does not exceed
the meal count for the day.
Delayed Implementation
(Provision 2 only)
Enables schools to charge students in reduced price and
paid meal categories in the base year for first claiming
period only.
Direct Certification Process of establishing children's eligibility for benefits by
obtaining documentation directly from the Department of
Economic Security (DES). Households determined eligible
for meal or milk benefits through direct certifications are
not required to submit a free and reduced-price application
to the school; instead they provide the DES notification,
titled Free Meals Programs.
Special Assistance Guidance Manual 44
Appendix
Glossary of Terms
FDPIR (Food Distribution
Program on Indian
Reservations)
Enables families on certain Indian Reservations who meet
Supplemental Nutrition Assistance (SNAP) income
guidelines to receive commodity foods.
Free Meal Meals served under the National School Lunch Program or
School Breakfast Program to a child from a household
eligible for such benefits. Neither the child nor any
household member can be required to work in the school
or in the school's food service to supplement the cost of
the meal.
NSLP (National School Lunch
Program)
Program under which participating schools operating a
nonprofit food service operation receive cash assistance
and donated food assistance.
Non-Pricing Program All enrolled students receive meals at no charge despite
their eligibility status. Meals are claimed for
reimbursement by the students' eligibility status.
Point of Service Meal Counts Meals are counted at that point in the food service
operation where it can be accurately determined that a
reimbursable free, reduced-price or paid meal has been
served to an eligible student.
Pricing Program Charging children eligible for reduced-price and paid meals.
Only an option for Provision 3 in a non extended base year.
Reduced-Price Meal A meal served under the National School Lunch or School
Breakfast Program to a child from a household eligible for
such benefits. The price of this meal MUST be less than the
full price of the meal and no more than 40 cents for lunch
and 30 cents for breakfast. Neither the child nor any
household member can be required to work in the school
or in the school's food service to supplement the cost of
the meal.
SBP (School Breakfast
Program)
Federally assisted meal program operating in schools and
institutions. It provides nutritionally balanced, low-cost, or
free breakfasts to children each school day.
Special Assistance Guidance Manual 45
Appendix
Glossary of Terms
SFA (School Food Authority) Governing body responsible for the administration of one
or more schools and either has the legal authority to
operate School Nutrition Programs in these schools or is
otherwise approved by the Food and Nutrition Service to
operate School Nutrition Programs.
USDA (United States
Department of Agriculture)
Federal agency designated by Congress to administer the
National School Lunch, School Breakfast, Special Milk
Programs, After School Care Snack, and Summer Food
Programs.
Verification Confirmation of eligibility for free and reduced price meals
under the National School Lunch or School Breakfast
Program. Verification must include confirmation of income
eligibility or confirmation that the child is included in a
currently certified Supplemental Nutrition Assistance
(SNAP)/FDPIR/TANF household or CA unit. At State or local
discretion, verification may also include confirmation of
any other information on the application, which is required
as a condition of eligibility.
Special Assistance Guidance Manual 46
Arizona Department of Education
Tom Horne, Superintendent of Public Instruction
The Arizona Department of Education does not discriminate on the basis of race, religion, color, national
origin, sex, disability or age in its programs, activities or in its hiring and employment practices. If you
have questions or grievances related to this policy, please contact the Administrative Services DAS at
(602) 542-3186.

Copyright to this resource is held by the creating agency and is provided here for educational purposes only. It may not be downloaded, reproduced or distributed in any format without written permission of the creating agency. Any attempt to circumvent the access controls placed on this file is a violation of United States and international copyright laws, and is subject to criminal prosecution.

Arizona Department of Education
Tom Horne, Superintendent of Public Instruction
Special Assistance Guidance Manual 2
TABLE OF CONTENTS
Chapter 1 - Introduction Page(s)
 Special Assistance Overview 3-6
 Impact of Special Assistance on Programs 7-12
 Special Assistance Case Studies 13-16
 How to Apply 17
 Participation Requirements 17
Chapter 2 – Operating a Base Year
 Administrative Requirements 18
 Claiming 18-20
 Administrative Review 20
 Approval 20
Chapter 3 - Operating a Non - Base Year
 Provision 2 Administrative Requirements 21
 Provision 2 Reimbursement Claims 21-24
 Provision 3 Administrative Requirements 25
 Provision 3 Reimbursement Claims 25-28
 Administrative Review 28
 Extensions 28
 End of Cycle 29
Chapter 4 – Administrative Resources
 Special Assistance Application 31
 Free and Reduced Price Policy Statement 32-36
 Extension Application 37
 Provision 2 Checklist 38
 Provision 3 Checklist 39
 Edit Check Spreadsheet 40
 Provision 2 Claiming Percentage Spreadsheet 41
 Provision 3 Meal Claim Calculation Spreadsheet 42
Appendix
 Glossary of Terms 43-45
Special Assistance Guidance Manual 3
CHAPTER 1 – INTRODUCTION
Special Assistance Overview
Traditionally, schools annually distribute household meal applications to families of all enrolled
children and make determinations of eligibility for free and reduced-price meals under the
National School Lunch Program (NSLP) and School Breakfast Program (SBP). In addition, schools
must count the number of meals served by category (free, reduced-price, and paid) and claim
meals in these categories. In an effort to reduce paperwork and other administration costs at
the local level, Congress incorporated into Section 11(a)(1) of the Richard B. Russell National
School Lunch Act (42 USC 1759a) three alternative Provisions to the traditional requirements
for annual determination of eligibility for free and reduced-price school meals and daily meal
counts by type. These alternatives are commonly referred to as Provision 1, 2, and 3. However,
Arizona only allows participation in Provision 2 and 3.
Special Assistance Guidance Manual 4
CHAPTER 1 – INTRODUCTION
Provision 2
Provision 2 is an option that enables sponsor’s to provide free meals to all of their students
while reducing paperwork and administrative costs. Under Provision 2, all students receive free
meals, regardless of income, and sponsor’s collect applications for free and reduced-price
meals once every four years, at most. Also, sponsor’s do not have to track and record the
different categories of meals served for at least three out of every four years. Sponsors pay
the difference between the cost of serving meals at no charge to all students and the federal
reimbursement for the meals.
Provision 2 is a four year cycle that establishes a CLAIMING PERCENTAGE in your base year (1st
year) which is then used for the following three non-base years (2nd, 3rd, 4th). For example, if
you were to start Provision 2 in the 2009-2010 school year:
Year 1 (base year) Year 2 (non-base yr) Year 3 (non-base yr) Year 4 (non-base yr)
2009-2010 2010-2011 2011-2012 2012-2013
Each base year MUST start at the beginning of the school year. During the base year, standard
meal counting and claiming procedures would still need to be followed, however, SFA’s would
offer meals to all students at no cost. This needs to be done in order to determine the claiming
percentages from the students’ eligibility status. Since household applications are collected and
status is determined, a claiming percentage can be derived. The claiming percentages
represent the ratio of meals served in each category to the total reimbursable lunch and/or
breakfast meals served.
For example: There are a total of 1,000 meals served in a month. Since each meal is recorded
by category in the base year, the following percentages are obtained:
Eligibility
Category
Total Meals Served By
Eligibility Category
÷ Total Meals
Served
= Claiming
Percentage
Free 800 ÷ 1,000 = 80%
Reduced 100 ÷ 1,000 = 10%
Paid 100 ÷ 1,000 = 10%
Special Assistance Guidance Manual 5
CHAPTER 1 – INTRODUCTION
A claiming percentage is calculated for each month during the base year and would then be
used during the next three non-base years.
During approved years (non-base years) of the Provision 2 cycle, the advantages include:
 Exemption from administrative requirements associated with collection of
household applications (certification) and conducting verification
 Increased participation and reimbursement in the meal program
 Simplified counting at the point of service
 Simplified claiming alternative based on established claiming percentages
Disadvantages include:
 Difficulty obtaining household applications for certification in future base years
 Financial risk due to a loss of revenues from reduced-price and paid meals when
operating a pricing program
Provision 3
Under Provision 3, the amount of reimbursement paid for the base year is paid during the next
4 years. This amount is adjusted annually for enrollment and inflation. The daily number of total
meals served must be recorded so that meal participation levels are monitored.
Provision 3 is a five year cycle that establishes an AMOUNT OF REIMBURSEMENT in the base
year (1st year) and that amount is used for the following four non-base years (2nd – 5th). For
example if you were to start Provision 3 in the 2009-2010 school year the cycle would be:
Year 1
(base year)
Year 2
(non-base yr)
Year 3
(non-base yr)
Year 4
(non-base yr)
Year 5
(non-base yr)
2009-2010 2010-2011 2011-2012 2012-2013 2013-2014
Special Assistance Guidance Manual 6
CHAPTER 1 – INTRODUCTION
The base year MUST start at the beginning of the school year. During the base year, standard
meal counting and claiming procedures would be followed; however, schools can choose to
operate a non-pricing or pricing program. Schools are encouraged to offer all meals at no cost
to have optimal participation and develop a level of reimbursement that may be more
reflective of participation during the base year. The amount of reimbursement that the school
receives in the first year is the amount that they will receive throughout the following four non-base
years. However, there is a monthly adjustment based on enrollment, number of serving
days, and inflation that may affect reimbursement.
During approved years (non-base years) of the Provision 3 cycle, the advantages include:
 Exemption from administrative requirements associated with collection of
household applications (certification) and conducting verification
 Simplified counting at the point of service
 Simplified claiming alternative based on base year reimbursement
Disadvantages include:
 Difficulty obtaining household applications for certification in future base years
 Financial risk due to a loss of revenues from reduced-price and paid meals when
operating a pricing program
Provision 2 and 3 - Breakfast Only Option
The Breakfast Only option allows sponsors to participate in a non-pricing program during
breakfast and to take advantage of simplified counting procedures at breakfast. This option is a
good alternative for sponsors seeking to expand their breakfast participation.
During approved years (non-base years) of the Breakfast Only option, the advantages include:
 Simplified counting at the point of service
 Simplified claiming alternative based on established claiming percentages (provision
2) or enrollment adjusted meals (provision3) for breakfast only
 Increased participation and reimbursement in the breakfast program
*Sponsors participating in the Breakfast Only option are still required to complete certification, verification, and
normal counting/claiming for lunch.
Special Assistance Guidance Manual 7
CHAPTER 1 – INTRODUCTION
Summary of Provision 2 and 3
Impact of Special Assistance
Operating under a non-pricing program can increase participation and therefore, positively
impact students in a number of ways. Studies demonstrate that students who participate in the
NSLP and SBP improve:
 School attendance
 Student behavior
 Test scores
While the benefits that the program has on students are well known, it is important to
understand the financial impact of operating under Special Assistance. In general, SFA’s that
understand and excel in the following areas have success financially.
 Certification/Verification Process
o District wide outreach to encourage parents to complete household applications
o Competent, well trained, and organized determining official
o Utilization of a well trained confirming official
o Utilization of Direct Certification throughout the school year
o Maintenance of an accurate benefit issuance document (meal count roster)
 Counting/Claiming Process
o Point of Service located at the end of the line and that matches/verifies a
student’s reimbursable meal to the benefits issuance document
o Accurately consolidating and verifying meal counts
Provision 2 Provision 3
Length of cycle Every 4 years Every 5 years
Length of cycle on extension 4 years 4 years
Base year meal type Non pricing Non pricing or standard pricing
Reimbursement type Claiming Percentage Amount of reimbursement
Enrollment/Serving Day adjustments No Yes
Option of Delayed Implementation Yes No
Special Assistance Guidance Manual 8
CHAPTER 1 – INTRODUCTION
*The Certification/Verification and Counting/Claiming processes directly determine the amount of
reimbursement that will be received during non-base years. Investing in the staff to execute these processes
during the base year will result in increased revenue during the non-base years.
 Menu Planning/Process Controls
o Offering a nutritious, well balanced menu that students enjoy will help maximize
student participation
o Execution of well planned cycle menus that utilize established process controls
such as: product specifications/order guides, standardized recipes, and correct
use of production records.
*How effectively a menu is planned/executed impacts the financial success of all food service programs.
 Labor
o Re-distribution/reduction of labor in non-base years to offset reduced
administrative duties associated with certification, verification, and
counting/claiming in base years.
*Labor re-distribution/reduction is one of the key cost savings (during non-base years) associated with operating
Special Assistance.
Financial Analysis
To determine the amount of labor and other savings throughout the school year, consider the
following:
1. How many labor hours are spent on processing household applications?
a. Preparing applications to be sent out
i. Include all sites
b. Initial collection of applications
c. Certifying eligibility status
d. Conducting direct certification and verification
e. Continuously collecting, updating and organizing applications
2. How many labor hours are used at the point of service?
a. Counting each student by eligibility status
b. Entering counts into a Point of Sale (POS) system
3. How much do supplies cost?
a. Printing
b. Distributing (postage etc.)
4. Other costs associated with traditional NSLP?
a. Hardware and technical support costs for POS system
Special Assistance Guidance Manual 9
CHAPTER 1 – INTRODUCTION
If food service costs are greater than federal reimbursement, other non-federal funds must
make up the difference.
To gain a better understanding of how your current program may be impacted by participating
in Special Assistance you can use the following Special Assistance Financial Analysis Tool.
Financial Analysis Tool Instructions
You can access the Special Assistance Financial Analysis Tool at the following website:
www.ade.az.gov/health-safety/cnp/sa/.
From the website, click Financial Analysis, and then click . This displays the
Excel spreadsheet on your screen and you can begin entering your information. When finished,
be sure to save the spreadsheet.
You must have Microsoft Excel version 97 or higher on your computer to use this tool. Follow
the onscreen directions to enter your information in the spaces provided.
You may not see the colored boxes on these pages, but you will see them on the website. A
green cell indicates a place for you to enter information. A blue cell indicates a place where the
spreadsheet displays calculations from the numbers you entered. A red triangle ( ) in the corner
of a cell indicates an attached comment that you can view in Excel.
Section A: Annual Revenue from Meals Served
1. Enter your school name in the space provided.
2. Enter the number of serving days in this school year.
3. For Sections 3, 4, and 5 enter data from your most recently completed month. For example, if today
is February 5, use data from January. You will use the numbers entered in this section to estimate
your increased participation in Part 3.
4. Enter the meal counts for the most recently completed month. Unless you are a single site school
district, this information does not come from the claim form but from a worksheet used to compile
the figures for the claim form.
Special Assistance Guidance Manual 10
CHAPTER 1 – INTRODUCTION
5. Enter the total amount of a la carte sales for the month you are using. Estimate the total food cost
of all a la carte items. You want the gross profit from these sales.
6. For sections 6 and 7, the spreadsheet calculates the total average daily revenue and the annual
revenue for meals served to students.
Section B: Annual Cost of Meals Served to Students
For Sections 1, 2, and 3 enter your data for the most recently completed fiscal year. You may
have to estimate the food cost for a single breakfast and a single lunch.
1. Enter the average cost per meal in each space.
2. Enter the annual cost of labor for your school.
3. Enter the cost per meal for non-food supplies.
Special Assistance Guidance Manual 11
CHAPTER 1 – INTRODUCTION
4. Enter the amount your school has decided will not be collectible.
5. The spreadsheet calculates this information for you.
Section C. Estimates for Provision 2 and 3
From Section A3, you have your current level of participation.
1. Now estimate what you think your increased level of participation will be. The participation should
be higher due to the non-pricing operation. The system calculates this information for you.
2. Enter the estimated decrease in labor costs. Using Special Assistance eliminates certain tasks, such
as application collection and meal counts by category. This should help to decrease your labor
expenses.
3. Estimate your decrease in a la carte sales and your estimated savings on cost of computerized meal
count system. The system, using your information, calculates the write offs and net estimate.
Special Assistance Guidance Manual 12
CHAPTER 1 – INTRODUCTION
Section D. Balance if Provision 2 or 3 is adopted.
Special Assistance Guidance Manual 13
CHAPTER 1 – INTRODUCTION
Special Assistance Case Studies
Inner City District
Number of Schools 20 Schools (16 = K-8, 2 = K-4, 2 = 6-8)
Total Enrollment ~ 11,000
Free and Reduced Percentage Range 72% - 97%
Background
This district is located in downtown Phoenix. The free and reduced percentage ranges between
72% and 97% between the 20 schools. Participation is high at approximately 85% for lunch and
moderately high at approximately 40% for breakfast. Enrollment has dropped some with new
charter schools opening in the attendance area.
Assessment
Special Assistance would be a good fit for this district because of the very high free and reduced
percentages, high participation and minimal drop in enrollment.
Decision
The district chose to implement Provision 3 due to the stable enrollment and to realize savings
by lowering labor costs associated with certification, verification, and counting/claiming duties.
Special Assistance Guidance Manual 14
CHAPTER 1 – INTRODUCTION
Reservation District
Number of Schools 1 School (K-8)
Total Enrollment ~ 180
Free and Reduced Percentage Range 96%
Background
This small school (also the district) is located on the Navajo Indian reservation in Northern
Arizona. The school is isolated and has a very high free and reduced percentage. The school
lunch and breakfast program is non-pricing.
Assessment
Because the school is non-pricing and enrollment is very steady, they are an ideal candidate for
Special Assistance, particularly Provision 3. There should not be a revenue loss because
students will not have any co-pays for lunch or breakfast. This school passed their latest
Coordinated Review Effort (CRE) and all proper administrative systems are in place.
Decision
The district chose to implement Provision 3 due to the static enrollment and to realize savings
in decreased labor costs associated with certification, verification, and counting/claiming
duties.
Special Assistance Guidance Manual 15
CHAPTER 1 – INTRODUCTION
Small Rural District
Number of Schools 3 Schools(1 = K-5, 1= 6-8, 1= 9-12)
Total Enrollment ~ 820
Free and Reduced Percentage Range 68% district wide (75% elementary)
Background
This small district is located in rural Arizona. The primary industry for the community is
agriculture and enrollment has been steady for several years. Even though the high school is an
open campus, there are very few competing lunch locations (i.e. McDonalds, Taco Bell, etc.)
Participation at the elementary school, among all categories (free, reduced and paid) is very
high, especially at lunch.
Assessment
This district currently collects in cash/checks $61,000 annually, from paid and reduced price
eligible students. Under Provision 2 or 3 this revenue would be forfeited, however the district
can realize certain savings in labor. The District estimates that it will save a half hour each day
by not performing categorized meal counts. In addition, five weeks each year (200 hrs.) will be
saved in labor by not collecting applications or performing verification. Unfortunately, the
difference between lost revenue and potential savings is still a negative $12,000. The District
would be required to subsidize any loss in the foodservice program.
Decision
The District chose not to implement Provision 2 or 3 because of the negative financial impact
on the Food Service department.
Special Assistance Guidance Manual 16
CHAPTER 1 – INTRODUCTION
Breakfast Only District
Number of Schools 13 Schools(7 = K-5, 4= 6-8, 2= 9-12)
Total Enrollment ~ 2900
Free and Reduced Percentage Range 70% – 75% at two elementary schools
Background
This district in Maricopa County is interested in implementing Special Assistance at the two
elementary school sites with the highest percentage of free and reduced eligible students. The
free and reduced percentage at the two schools is between 70-75%. The Superintendent asked
his business manager to prepare a financial statement to help determine what the financial
impact would be if the SFA participated in Special Assistance at breakfast and lunch.
Assessment
Because the two schools are less than 75% of free and reduced eligible students, implementing
Special Assistance will cause a significant revenue loss to the overall program. However, the
Superintendent is still interested in how the food service finances would be affected by
implementing Special Assistance for breakfast only.
It was determined that there would be a loss of approximately $2,000 if a non-pricing breakfast
was implemented; however, if there was a slight increase in participation among the free and
reduced students, it has the potential to offset the loss.
Decision
The sponsor decided to implement Provision 2 – Breakfast only because the increased student
participation would offset the revenue loss. The decision was based on the overwhelming
evidence that students learn better when they eat breakfast.
Special Assistance Guidance Manual 17
CHAPTER 1 – INTRODUCTION
How to Apply
Any sponsor who has participated in the NSLP for two years may apply to participate in the
Special Assistance program beginning their third year on the NSLP program year. New sponsors
must submit an original signed copy of the Special Assistance application no later than May 1st.
The Special Assistance application can be found at the following website:
www.ade.az.gov/health-safety/cnp/sa/
Participation Requirements
Once a completed application is received, the Arizona Department of Education (ADE) will
verify that the sponsor has participated in the NSLP for a minimum of two years. ADE will notify
the sponsor (by memo, no later than May 15th) of the requirements for entering a base year.
The base year requirements include the following:
 Submit a completed signed original copy of the Free and Reduced-Price policy statement
prior to the first day of school
 Distribute household applications, parent letters, and media release prior to the first
day of school
 Attend A+ School Lunch workshops (Day 1) and Provision 2 & 3 training prior to the first
day of school
*Failure to meet the above requirements by the first day of school will result in a denial of the request to
participate in Special Assistance. All sponsors who do not meet requirements may re-apply to participate
beginning the following school year.
To see training dates/times and to register please visit www.ade.az.gov/onlineregistration
Special Assistance Guidance Manual 18
CHAPTER 2 – OPERATING A BASE YEAR
Administrative Requirements
Once approved to enter in to a base year, the sponsor will operate the program under normal
NSLP operating conditions. This includes, but is not limited to, the following Key Administrative
Areas:
 Distribution, collection, and certification of school year household applications in
accordance with program guidelines
 Completion of Direct Certification within the first thirty operating days of the school
year
 Completion of the verification process and reporting in accordance with program
guidelines
 Counting/claiming of meals based on benefits issued during the certification process for
the entire school year
 Provision 2 sponsors must operate a non-pricing program
*Please remember that the benefits of the Special Assistance Program are not realized during the base year. The
program must operate in accordance with all NSLP program guidelines.
Base Year Reimbursement Claims
Standard claiming procedures (in accordance with NSLP guidelines) are used. Meals must be
counted at the point of service by eligibility category (free, reduced price, and paid) and
consolidated for each category for the monthly claims. All claims will continue to be processed
in CNP Web. See below for an example of the claim screen entry during base years.
Special Assistance Guidance Manual 19
CHAPTER 2 – OPERATING A BASE YEAR
Sample Base Year Claim – April 2009
If more than one site will be participating, each school must have their own eligibility data.
Also, breakfast, lunch, and snack counts must remain separate. The CNP web system will use
your monthly base year claims to automatically calculate claims in non-base years.
Regular Claim Entry
 Number of Days Served
 Meals by Eligibility Category
 Participants Approved by Category
 Participants Enrolled
Special Assistance Guidance Manual 20
CHAPTER 2 – OPERATING A BASE YEAR
* The data submitted in these base year claims can be used to show free and reduced percentages by month
(verification exempt reporting, e-rate audits, grants, etc.) as needed.
Claiming Requirements
Claims must be processed for each month in which program meals are served. Sponsors
conducting a base year following the end a previously approved provision cycle (breakfast and
lunch) are not eligible for the 30-day eligibility rollover to start the school year. Provision status
offers a claiming alternative to individual sites and therefore no eligibility can be assigned to
individual students. These students automatically default to a paid status when the initial
certification process begins.
Administrative Review
During the base year, the ADE will conduct an administrative review to verify compliance with
NSLP regulations. The administrative review may be conducted as one of the following:
 Coordinated Review Effort (CRE) – regularly scheduled review
 CRE Follow-Up – regularly scheduled review to follow-up on previous year’s CRE
 Abbreviated Review – an additional administrative review conducted outside of the
regular CRE schedule
ADE will review compliance in the following key Administrative Areas:
 Certification
 Counting/Claiming
 Verification
A final determination will be made to certify the base year for the Sponsor’s entrance into the
Special Assistance program. Sponsors that do not meet regulations during their administrative
review will be sent a Special Assistance Unsatisfactory Base Year memo. Sponsors with an
Unsatisfactory Base Year may re-apply to participate in the program the following year.
Approval
Sponsors that successfully complete a base year will receive a Special Assistance Certification
Memo that outlines the approved Provision 2 or 3 cycle and describe the requirements during
the non-base years. The Certification Memo should be retained by the sponsor to document
the approved Provision 2 or 3 cycle.
Special Assistance Guidance Manual 21
CHAPTER 3 – OPERATING A NON-BASE YEAR
Provision 2 Administrative Requirements
Breakfast and Lunch
Once the base year is approved the sponsor will be able to operate under Provision 2 status for
a period of three years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast and lunch program for each non-base year
 Maintain all base year records for a period of five years after the completion of the
approved provision cycle
 Attend Provision 2 and 3 training during each non-base year
 Submit the Verification exempt report prior to March 1st of each school year
During the approved non base years, the approved sites are considered exempt from
Certification and Verification and may NOT complete the following:
 Distribute and/or collect household applications
 Conduct Direct Certification (unless approved as part of an extension application)
*Distribution of household applications and/or conducting direct certification (at approved sites) during a non-base
year will result in forfeiture of Special Assistance status.
Breakfast Only
Once the base year is approved, the sponsor will be able to operate under Provision 2 status for
a period of three years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast program for each non-base year
 Attend Provision 2 and 3 training or A+ School Lunch Workshop (Day One) during each
non-base year
Provision 2 Reimbursement Claims
Breakfast and Lunch
At the completion of the base year, the established monthly claiming percentages are used to
calculate non-base year claims. The school will still continue to use CNP Web to enter claims.
However, only the total number of meals served and serving days for the claim month will be
entered in CNP web. The computer will calculate the number of reimbursable meals per
category by multiplying the total meals served by the established claiming percentage.
Special Assistance Guidance Manual 22
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 2 Claim (Breakfast and Lunch) – April 2009
During the non-base years the total amount of meals served will be reimbursed according to
the claiming percentage. The established claiming percentages (April of base year) in the above
situation were as follows:
Provision 2 (Breakfast/Lunch) Claim Entry
 Number of Days Served
 Total Meals Served
 Participants Enrolled
CNP Web Calculates
 Meals Served by Category
Special Assistance Guidance Manual 23
CHAPTER 3 – OPERATING A NON-BASE YEAR
Breakfast
BY Claiming Percentage x Total Meals Served = Adjusted Reimbursable Meals
62.64% Free x 6960 = 4360
11.18% Reduced x 6960 = 778
26.18% Paid x 6960 = 1822
Lunch
BY Claiming Percentage x Total Meals Served = Adjusted Reimbursable Meals
69.70% Free x 13659 = 9520
10.72% Reduced x 13659 = 1465
19.57% Paid x 13659 = 2674
Breakfast Only
At the completion of the base year, the established monthly claiming percentages are used to
calculate claims for breakfast only. The computer will calculate the number of reimbursable
breakfast meals per category by multiplying the total meals served by the established claiming
percentage. The regular claiming process by eligibility category still occurs for lunch.
Special Assistance Guidance Manual 24
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 2 Claim (Breakfast Only) – April 2009
Claiming percentages for breakfast are calculated in the same manner as described in the
previous example.
Provision 2 (Breakfast) Claim Entry
 Number of Days Served
 Total Meals Served
 Participants Enrolled
CNP Web Calculates
 Meals Served by Category
Regular Lunch Claim Entry
 Number of Days Served
 Meals by Eligibility Category
 Participants Approved by Category
 Participants Enrolled
Special Assistance Guidance Manual 25
CHAPTER 3 – OPERATING A NON-BASE YEAR
Provision 3 Administrative Requirements
Breakfast and Lunch
Once the base year is approved, the sponsor will be able to operate under Provision 3 status for
a period of four years. During these non-base years the sponsor is required to comply with the
following:
 Operate a non-pricing breakfast and lunch program for each non-base year
 Maintain all base-year records for a period of five years after the completion of the
approved provision cycle
 Attend Provision 2 and 3 training during each non-base year
 Submit the Verification exempt report prior to March 1st of each school year
During the approved non-base years, the approved sites are considered exempt from
Certification and Verification and may NOT complete the following:
 Distribute and/or collect household applications
 Conduct Direct Certification (unless approved as part of an extension application)
*Distribution of household applications and/or conducting direct certification (at approved sites) during a non-base
year will result in forfeiture of Special Assistance status.
Provision 3 Reimbursement Claims
At the completion of the base year, the monthly amount of reimbursement will be used to
calculate non-base year claims. The sponsor will still continue to use CNP Web to enter in
claims. However, only the total number of meals served, the current enrollment as of the end
of the month, and the number of serving days will be entered. The computer will calculate the
number of reimbursable meals per category based on the enrollment and serving day changes.
The calculated total meals are multiplied by the current reimbursement rates to determine the
total amount of reimbursement.
Special Assistance Guidance Manual 26
CHAPTER 3 – OPERATING A NON-BASE YEAR
Sample Provision 3 Claim – May 2009
During the non-base years the percent change in enrollment, enrollment adjusted meals by
category, and serving day adjustments are used to calculate the total reimbursement.
Provision 3 Claim Entry
 Number of Days Served
 Participants Enrolled
 Total Meals Served
Special Assistance Guidance Manual 27
CHAPTER 3 – OPERATING A NON-BASE YEAR
Lunch Example
Percent Change Enrollment
Current Enrollment ÷ Base Year Enrollment = Enrollment Change
328 ÷ 365 = .8986
Enrollment Adjusted Meals
Base Year Meals x Enrollment Change = Enrollment Adjusted Meals
3827 (Free) x .8986 = 3439
1521 (Reduced) x .8986 = 1367
1509 (Paid) x .8986 = 1356
Serving Day Adjusted Meals
Enrollment Adjusted
Meals
÷ Base Year
Serving Days
x Current Year
Serving Days
= Serving Day Adjusted
Meals
3439 (Free) ÷ 23 x 14 = 2093
1367 (Reduced) ÷ 23 x 14 = 832
1356 (Paid) ÷ 23 x 14 = 825
The serving day adjusted meals are multiplied by the current year reimbursement rates to
determine the total reimbursement. The same calculations are completed for breakfast and
lunch.
Breakfast Only
At the completion of the base year, enrollment and serving day adjusted meals are used to
calculate claims for breakfast only. The serving day adjusted meals are multiplied by the
current year reimbursement rates to determine the total reimbursement. The regular claiming
process by eligibility category still occurs for lunch.
Special Assistance Guidance Manual 28
CHAPTER 3 – OPERATING A NON-BASE YEAR
Administrative Review
During non-base years ADE will conduct regularly scheduled CRE reviews. The CRE will include
an audit of base year records.
Extension
An extension allows the sponsor to continue Provision 2 or 3 for a new four year cycle. As a
result the school can serve meals at no cost for another four years without having to complete
a new base year. Sponsors must notify ADE by submitting and Application for Extension by May
1st of the 2nd non-base year. The Special Assistance Extension application can be found at the
following website:
www.ade.az.gov/health-safety/cnp/sa/
ADE will provide guidance on approved data that may be submitted based on information from
the extension application. All socio-economic data must meet the following criteria:
 Be reflective of the school’s population
 Be equivalent data for both the base year and the last year of the cycle
 Effectively measure whether the income level of the school’s population (adjusted for
inflation) has remained stable, declined or had only negligible improvement
Provided that the above criteria are met, pre-approved socio-economic data includes:
 Direct Certification results from the participating school/district
 Local Unemployment data
 Local Supplemental Nutrition Assistance Program (SNAP – formerly Food Stamp
Program)
 Food Distribution Program on Indian Reservation (FDPIR) results
 Temporary Assistance for Needy Families (TANF)
 Information collected by the city or county zoning and economic planning office
To obtain an extension the school must provide approved socio-economic data no later than
March 1st of the last non-base year. The approved socio-economic data will be evaluated by
ADE to ensure that the data does not exceed a five percent threshold level. Sponsors are
encouraged to submit approved data as early as possible during the last non-base year so that it
may be evaluated. ADE will notify sponsors of their extension status no later than May 15th.
Special Assistance Guidance Manual 29
CHAPTER 3 – OPERATING A NON-BASE YEAR
End of Cycle
All sponsors should refer to their initial Special Assistance Certification Memo to determine
when their approved cycle will end. As a courtesy, ADE will notify sponsors by memo that their
approved cycle has ended. The following options are available to sponsors at the end of the
cycle:
 Re-apply for the Special Assistance program by submitting a Special Assistance
Application
 Revert back to standard meal counting and claiming procedures
Special Assistance Guidance Manual 30
CHAPTER 4 – ADMINISTRATIVE RESOURCES
The following pages include resources for the Special Assistance program. Printable copies and
downloadable spreadsheets can be found on the Special Assistance website located at:
www.ade.az.gov/health-safety/cnp/sa/
 Special Assistance Application
 Free and Reduced Price Policy Statement
 Extension Application
 Base Year Checklist
 Non-Base Year Checklist
 Edit Check Spreadsheet
 Provision 2 Claiming Percentage Spreadsheet
 Provision 3 Claim Spreadsheet
Special Assistance Guidance Manual 31
Arizona Department of Education
Child Nutrition Program
Special Assistance Application
Please review the Special Assistance Guidance Manual. After reviewing the manual, if you would like to apply for the Special Assistance
Program, please complete this application. Once completed, submit the application to the Special Assistance coordinator at the Arizona
Department of Education, Child Nutrition Programs for review. Please note that this application is not approved until you receive an official
letter of approval from this department.
Sponsor Name: CTD#
Contact/Title: Phone #:
1. Indicate the Special Assistance provision that will be operated: Provision 2 or Provision 3
2. Indicate the number of sites that will be participating in the Special Assistance Program: _____________
Please attach on School District Letterhead a list of all sites. Please indicate the fields listed below.
NAME OF SCHOOL BASE YEAR BREAKFAST (B), LUNCH (L), OR BOTH (BL)
3. During the base year each sponsor must demonstrate compliance with all certification, counting/claiming, and verification procedures during
an administrative review. Is this requirement understood? Y____ N____
4. A sponsor may not supplement its meal service operation with any federal funds other than USDA reimbursement, BIA funds and any other
source earmarked for meal service. Is this requirement understood? Y____ N____
5. A qualified representative is required to attend the A+ School Lunch Workshop and Provision 2 & 3 training prior to the first operating day of
the base year and Provision 2 and 3 training in each non-base year. Is this requirement understood? Y____ N____
6. Have you read and understood the requirements of Special Assistance (see Special Assistance guidance manual)? Y____ N ____
I CERTIFY that the information in this application is true, and that I agree to carry out the terms of the agreement to operate the Special
Assistance Program. I understand that this information is given in connection with the receipt of federal funds and that deliberate
misinterpretation may be subject to prosecution under applicable federal statutes.
Print name (authorized signatory): ___________________________________________________________
Signature: _______________________________________________________________________________ Date: _________
________________FOR OFFICE USE ONLY______________
Date of Last Review: ____________________________ Passed: Y____N____
Approved: Y___ N____ Original Base Year: ____________________ Provision: ____
Approved By: ________________________ _____________________________________________ Date: _________
Additional Information/Comments:
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Base Year: ______ Extension Request Due: Next Base Year:
Special Assistance Guidance Manual 32
Free and Reduced Price Policy Statement
Policy Statement for Pricing Programs
This policy statement outlines regulations of the United States Department of Agriculture and will be
considered a permanent document. This statement applies to the programs in which the sponsor will be
participating as indicated on the application and agreement.
The SPONSOR assures the STATE AGENCY that the SPONSOR will implement a policy in
conformance with 7 CFR part 245.10 to determine children’s eligibility for free and reduced-price
benefits (meals and/or milk) in the National School Lunch, School Breakfast and Special Milk Programs
under its jurisdiction. In fulfilling its responsibilities, the SPONSOR shall:
1. Provide prescribed benefits free or at a reduced-price to children from families whose income
does not exceed DEPARTMENT guidelines or to children from food stamp households, Cash
Assistance (CA) or Food Distribution Program on Indian Reservations (FDPIR) assistance units
that provide a case number or are directly certified by the Department of Economic Security.
NOTE: The SPONSOR has two options if participating in the Special Milk Program: 1) to offer
milk free, or 2) to charge for milk, on a nonprofit basis.
2. Submit annually to the STATE AGENCY, Child Nutrition Programs Unit, copies of the
SPONSOR’S Parent Letter (including names of the reviewing officials and hearing official),
Income Application, Approval/Denial Notice, Meal Count System Information, the Free and
Reduced-Price Document Summary and After School Care Program Information, if the
SPONSOR is new to the program or if there have been changes to the previously approved forms.
3. If there have been no changes, submit the Free and Reduced-Price Document Summary and
indicate the options you have selected for the new program year. The Income Application,
Approval/Denial Notice and Meal Count System Information shall be deemed part of this policy
statement and will be made permanent. Changes to any of the above documents require the
approval of the STATE AGENCY, Child Nutrition Programs Unit.
4. Accept applications at any time during the year. If a child transfers from one school to another,
under the jurisdiction of the same SPONSOR, eligibility for free or reduced-price benefits will be
transferred to and honored by the receiving school. All children from a family which receives the
same benefits shall be notified within ten working days of the acceptance or denial of their
application. Children shall be served immediately upon the establishment of their eligibility.
5. When an application is rejected, parents or guardians shall be informed in writing of the reason
for denial and of the hearing procedures herein provided. Parents shall be notified that they may
reapply for free and reduced-price benefits or free milk at any time during the school year. The
SPONSOR shall designate as a hearing official someone not involved in the original eligibility
determination, preferably someone in a position superior to that of the determining official.
6. Establish a hearing procedure under which: (1) a family may appeal a decision made by the
School Food Authority with respect to an application the family has made for free or reduced-price
meals or for free milk, and (2) the School Food Authority may challenge the continued
eligibility of any child for a free or reduced-price meal or for free milk. The hearing procedure
shall provide for both the family and the School Food Authority:
Special Assistance Guidance Manual 33
a. A simple, publicly announced method to make an oral or written request for a hearing;
b. An opportunity to be assisted or represented by an attorney or other person;
c. An opportunity to examine, prior to and during the hearing, any documents and records
presented to support the decision under appeal;
d. Assurance that the hearing shall be held with reasonable promptness and convenience,
and that adequate notice shall be given as to the time and place of the hearing;
e. An opportunity to present oral or documentary evidence and arguments supporting a
position without undue interference;
f. An opportunity to question or refute any testimony or other evidence and to confront and
cross-examine any adverse witnesses;
g. Assurance that the hearing shall be conducted and the decision made by a hearing official
who did not participate in making the decision under appeal or in any previously held
conference;
h. Assurance that the decision of the hearing official shall be based on the oral and
documentary evidence presented at the hearing and made a part of the hearing record;
i. Assurance that the parties concerned and any designated representative shall be notified
in writing of the decision of the hearing official;
j. Assurance that a written record shall be prepared with respect to each hearing, which
shall include the challenge or the decision under appeal, any documentary evidence and a
summary of any oral testimony presented at the hearing, the decision of the hearing
official, including the reasons therefore, and a copy of the notification to the parties
concerned of the decision of the hearing official;
k. Assurance that the written record of each hearing shall be preserved for a period of five
years and shall be available for examination by the parties concerned or their
representatives at any reasonable time and place during that period;
l. Notice that benefits already ongoing shall be continued until ten working days after a
decision has been reached by the hearing official;
m. Notice that households that have been approved for benefits and that are subject to a
reduction or termination of benefits later in the same school year shall receive continued
benefits if they appeal the adverse action within the 10-calendar-day advance notice
period; and
n. Notice that households that are denied benefits upon application shall not receive
benefits.
7. Not segregate or discriminate against any child because of inability to pay the full price. Further
assurance is given that:
Special Assistance Guidance Manual 34
a. The names of the children shall not be published, posted, or announced in any manner,
unless an approved multi-use application is in use;
b. There shall be no overt identification of any of the children by the use of special tokens,
tickets, or by any other means. The children shall not be required to work for their meals
or milk;
c. The children shall not be required to use a separate dining area, go through a separate
serving line, enter the dining area, or consume their meals or milk at a different time;
d. When more than one lunch, breakfast, or type of milk is offered which meets the
requirements of 7 CFR parts 210.10, 220.8 or 215.2, the children shall have the same
choice of meals and/or milk that is available to those children who pay the full price for
their meals and/or milk; and
e. Children shall not be discriminated against because of race, color, national origin, gender,
religion, age, disability, political beliefs, sexual orientation and marital or family status.
8. Make determinations of eligibility for free or reduced-price benefits specified in 7 CFR part 245.
Officials shall use the criteria referred to in this policy for the household application.
9. Distribute to each child’s parent or guardian a letter announcing eligibility criteria as required in 7
CFR part 245.5(a) and an application form for free or reduced-price benefits at the beginning of
each school year and whenever there is a change in eligibility criteria.
10. Make available the free and reduced-price guidelines and other information contained in the
parent letter to local unemployment offices and major employers contemplating large layoffs in
the area from which its attendance is drawn as required in 7 CFR part 245.5(a).
11. Verify approved free and reduced-price applications by December 15 as specified by 7 CFR part
245.6a. Maintain a description of the verification activities as required by CFR part 245.6a 3(c).
12. Have the opportunity to determine children as eligible for free meals or free milk based on Direct
Certification in place of information submitted by the household on the household application.
Direct Certification forms must be retrievable by school.
13. Agree that the STATE AGENCY will submit a public/press release containing both free and
reduced-price eligibility guidelines and other information required to be contained in parent letter
to news media. The SPONSOR agrees to submit a public/press release to local unemployment
offices and major employers contemplating or experiencing layoffs.
Policy Statement for Non Pricing Programs (Check box of Provision that applies)
The SPONSOR warrants and represents that:
1. All children in attendance or residence are being served the same choice of meals and/or milk
at no separate charge.
2. The SPONSOR has data on all children claimed for free or reduced-price benefits and assures
the STATE AGENCY that each child receiving such benefits meets the prescribed eligibility
criteria.
Special Assistance Guidance Manual 35
3. A daily count is kept by meal type for all meals and/or milk claimed.
 Special Assistance - Provision 2 Programs, Additional Requirements if applicable
A School Food Authority which oversees a school serving meals free of charge to all enrolled children in
that school may publicly notify and certify children for free and reduced-price meals for up to four
consecutive school years, provided that eligibility determinations shall be in accordance with 7 CFR part
245.3 during the first school year. The following requirements shall apply:
1. Except for assistance properly made available under parts 210, 220, 240, 250, the Indian Child
Welfare Act 95-608, and by other legislation, a School Food Authority of a school operating under
Provision 2 requirements agree to pay with funds from other than federal sources for:
a. Meals served to children not eligible for free or reduced-price meals; and
b. The differential between the per-meal cost and federal reimbursement received for each free
or reduced-price meal, respectively, served to children eligible to receive such meals under
applicable program regulations.
2. In the first year (base year), schools must take daily counts each month of the number of meals served
by meal type (free, reduced-price, and paid) and convert the number of each meal type to a percentage
of total meals served for the month. The percentages are derived by dividing the monthly total
number of meals served by one meal type (e.g. free) by the total number of meals served the same
month for all meal types (free, reduced-price, and paid).
3. For the purpose of calculating reimbursement claims, for the second, third, and fourth school years,
the three percentages, calculated at the end of each month of the first school year (base year), shall be
multiplied by corresponding monthly meal totals of all meal types (free, reduced-price and paid
meals).
4. Eligibility determinations from the base year must be maintained for as many years as necessary to
substantiate claims for reimbursement in the applicable Provision 2 cycle, including any extensions of
that cycle. Extensions may be granted based on pre-approved socioeconomic data which includes:
Direct Certification results from the participating school/district, local unemployment data, local
Supplemental Nutrition Assistance Program data, Food Distribution Program on Indian Reservation
(FDPIR) results, Temporary Assistance for Needy Families (TANF) and information collected by the
city or county zoning and economic planning office.
 Special Assistance - Provision 3 Programs, Additional Requirements if applicable
A School Food Authority which oversees a school serving meals free of charge to all enrolled children
may publicly notify and certify children for free and reduced-price meals for up to five consecutive school
years, provided that eligibility determinations shall be in accordance with 7 CFR part 245.3 during the
first school year. The following requirements shall apply:
1. Except for assistance properly made available under parts 210, 220, 240, 250, the Indian Child
Welfare Act 95-608, and by other legislation, a School Food Authority of a school operating under
Provision 3 requirements agrees, after the first year, to pay with funds from other than federal sources
for:
Special Assistance Guidance Manual 36
a. Meals served to children not eligible for free or reduced-price meals; and
b. The differential between the per-meal cost and federal reimbursement received for each free
or reduced-price meal, respectively, served to children eligible to receive such meals under
applicable program regulations.
2. Reimbursement in the four years following the first year (base year) will be determined by taking the
prior year’s reimbursement and adjusting for changes in enrollment and inflation. Meal counts are
not required to be taken during these years. Enrollment change must be based on the school’s
enrollment on October 31 annually.
3. Eligibility determinations from the base year must be maintained for as many years as necessary to
substantiate claims for reimbursement in the applicable Provision 3 cycle, including any extensions of
that cycle. Extensions may be granted based on pre-approved socioeconomic data which includes:
Direct Certification results from the participating school/district, local unemployment data, local
Supplemental Nutrition Assistance Program data, Food Distribution Program on Indian Reservation
(FDPIR) results, Temporary Assistance for Needy Families (TANF) and information collected by the
city or county zoning and economic planning office.
_________________________________________ ________________________________
(Print or Type Name and Title) (Authorized Signature)
_________________________________________ ________________________________
(Sponsor/School) (Date)
Special Assistance Guidance Manual 37
Arizona Department of Education
Child Nutrition Program
Application for an Extension on Special Assistance
Please review the Special Assistance Guidance Manual. After reviewing the manual, if you would like to apply for an extension on Special
Assistance Program, please complete this application. Once completed, submit the application to the Special Assistance coordinator at the
Arizona Department of Education, Child Nutrition Programs for review. Please note that this application is not approved until you receive an
official letter of approval from this department.
Sponsor Name: CTD#
Contact/Title: Phone #:
1. Indicate the Special Assistance Provision (2 or 3) that is currently being operated: Provision 2 or Provision 3
2. Indicate the number of special assistance sites that are being operated: _____________
Please attach on School District Letterhead a list of all sites. Please indicate the fields listed below.
NAME OF SCHOOL BASE YEAR BREAKFAST (B), LUNCH (L), OR BOTH (BL)
3. Please indicate the approved socioeconomic data that will be submitted to the Arizona Department of Education. Data submitted must be
from the base year and the last non base year. All data must be submitted by March 1st of the last non-base year.
Socioeconomic Data Source BASE YEAR LAST NON-BASE YEAR
I CERTIFY that the information in this application is true, and that I agree to carry out the terms of the agreement to operate the Special
Assistance Program. I understand that this information is given in connection with the receipt of federal funds and that deliberate
misinterpretation may be subject to prosecution under applicable federal statutes.
Print name (authorized signatory) ___________________________________________________________
Signature: ______________________________________________________________________________ Date:_________
________________FOR OFFICE USE ONLY______________
Date of Last Review: ____________________________ Passed: Y____N____
Approved: Y___ N____ Original Base Year: ____________________ Provision: ____
Approved By: __________________________________________ Date: __________
Additional
Information/Comments:_________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
Base Year: ______ Extension Request Due: Next Base Year:
Special Assistance Guidance Manual 38
Provision 2 Checklist
Applying
 Review the Special Assistance Guidance Manual
 Submit Special Assistance application no later than May 1st of school year prior to base year
 Submit and update Free and Reduced Price Policy Statement (check box for Provision 2)
 Attend A+ School Lunch Workshop (day one) prior to first day of school
 Attend Provision 2 and 3 training prior to first day of school
Base Year
 Distribute household applications to all families
 Send Non-Pricing letter to parents indicating ALL students may receive meals at NO cost
 Notify public that meals to ALL students will be served at NO cost
 Conduct Direct Certification, certify applications, conduct verification
 Accurately Count/Claim total number of reimbursable meals served at the point of service
by eligibility category
 Submit claims for each operational month during base year
 Indicate Special Assistance Base Year on CNP Web online applications
Non-Base Years 1 & 2
 Notify parents that meals will be provided to ALL students at no cost
 Count total number of reimbursable meals served at the point of service
 If requesting an extension, submit an application for extension no later than May 1st of the
2nd non-base year
 Attend Provision 2 and 3 training annually
Non-Base Year 3 (End of Cycle)
 Attend Provision 2 and 3 training
 If school will continue to operate under Special Assistance they must submit a Special
Assistance Application no later than May 1st
 If School has applied for an extension of Special Assistance
o Provide the Arizona Department of Education with specified socio-economic data no
later than March 1st
OR
 If School will no longer be operating under Provision 2 and will resort back to standard
operation
o Send notification letter to parents (at the end of the school year)
Special Assistance Guidance Manual 39
Provision 3 Checklist
Applying
 Review the Special Assistance Guidance Manual
 Submit Special Assistance application no later than May 1st of school year prior to base year
 Submit and update Free and Reduced Price Policy Statement (check box for Provision 3)
 Attend A+ School Lunch Workshop (day one) prior to first day of school
 Attend Provision 2 and 3 training prior to first day of school
Base Year
 Send household applications to all families
 Send Non-Pricing letter to parents indicating ALL students may receive meals at NO cost (if
applicable)
 Conduct Direct Certification, certify applications, conduct verification
 Accurately Count/Claim total number of reimbursable meals served at the point of service
by eligibility category
 Submit claims for each operational month during base year
 Indicate Special Assistance Base Year on CNP Web online applications
Non-Base Years 1, 2, & 3
 Notify parents that meals will be provided to ALL students at no cost
 Count total number of reimbursable meals served at the point of service
 If requesting an extension, submit an application for extension no later than May 1st of the
3rd non-base year
 Attend Provision 2 and 3 training annually
Non-Base Year 4 (End of Cycle)
 Attend Provision 2 and 3 training
 If sponsor has applied for an extension of Special Assistance
o Provide the Arizona Department of Education with specified socio-economic data no
later than March 1st
 If sponsor will continue to operate under Special Assistance they must submit a Special
Assistance Application no later than May 1st
OR
 If sponsor will no longer be operating under Provision 3 and will resort back to standard
operation
o Send notification letter to parents (at the end of the school year)
Special Assistance Guidance Manual
School Year
Free Total Free Total
1 0 0% 0 0%
2 0 0% 0 0%
3 0 0% 0 0%
4 0 0% 0 0%
5 0 0% 0 0%
6 0 0% 0 0%
7 0 0% 0 0%
8 0 0% 0 0%
9 0 0% 0 0%
10 0 0% 0 0%
11 0 0% 0 0%
12 0 0% 0 0%
13 0 0% 0 0%
14 0 0% 0 0%
15 0 0% 0 0%
16 0 0% 0 0%
17 0 0% 0 0%
18 0 0% 0 0%
19 0 0% 0 0%
20 0 0% 0 0%
21 0 0% 0 0%
22 0 0% 0 0%
23 0 0% 0 0%
24 0 0% 0 0%
25 0 0% 0 0%
26 0 0% 0 0%
27 0 0% 0 0%
28 0 0% 0 0%
29 0 0% 0 0%
30 0 0% 0 0%
31 0 0% 0 0%
Total 0 0 Total 0 0
Percent participation (Attendance Factor Adjusted) should not exceed 100% under normal circumstances and the total count should not exceed enrolled under any circumstances. Should this
percent exceed 100% please verify meal count accuracy. If no meal count errors are present please contact your program specialist regarding adjustment of established attendance factor.
Enrollment
Date
% Part.
Of Free
Daily Edit Check Worksheet
Attendance Factor =
Edit Check Calculation School Lunch Program Meals
% Part.
Of Free
Month
# # Lunches Served Pupils Breakfasts Served Pupils
Reimbursable Meals Reimbursable Meals
School Breakfast Program Meals
40
Special Assistance Guidance Manual
Provision 2 Base Year Claiming Percentage Calculator
Free Meals Served
= 0 Free Meals Served =
Reduced-Price Meals Served
= 0 Reduced-Price Meals Served =
Paid Meals Served
= 0 Paid Meals Served =
Total Meals Served
= 0 Total Meals Served =
Free Claiming Percentage
= 0.0000% Free Claiming Percentage = 0.0000%
Reduced Claiming Percentage
= 0.0000% Reduced Claiming Percentage = 0.0000%
Paid Claiming Percentage
= 0.0000% Paid Claiming Percentage = 0.0000%
School:
Month/Year:
Breakfast
Lunch
41
Special Assistance Guidance Manual
Provision 3 Lunch Meal Calculations
School:
Base Year Meals
Free = 0
Reduced-Price = 0
Paid = 0
Enrollment and Serving Days
Base Year Enrollment = 0
Base Year Serving Days = 0
Current Year Enrollment = 0
Current Year Serving Days = 0
Calculations
Total Meals = 0
Month: Year:
Percent Change Enrollment =
Current Year
Enrollment
/
Base Year
Enrollment
= 0 / 0 = 0.0000
Enrollment Adjusted Free Meals =
Base Year Free
Meals
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Enrollment Adjusted Reduced-
Price Meals
=
Base Year
Reduced -Price
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Enrollment Adjusted Paid Meals =
Base Year Free
Meals
X
Percent Change
Enrollment
= 0 X 0.0000 = 0.0000
Serving Day Adjusted Free
Meals
=
Enrollment
Adjusted Free
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
Serving Day Adjusted Reduced-
Price Meals
=
Enrollment
Adjusted
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
Serving Day Adjusted Paid
Meals
=
Enrollment
Adjusted Paid
/
Base Year Serving
Days
X
Current Year
Serving Days
= 0.0000 / 0 X 0 = 0
42
Special Assistance Guidance Manual 43
Appendix
Glossary of Terms
ADE Arizona Department of Education
Administrative Review Review conducted by Child Nutrition Program staff to
assess the adequacy of the eligibility certification process,
accuracy of the meal counting and claiming system, and
completion of the verification in the base year.
Annual Claiming Percentages
(Provision 2 only)
A school may add meal counts by category for the entire
base year and convert to claiming percentages for free,
reduced-price, and paid meals. The school then uses the
annual claiming percentage for each category for each
month of the non-base year.
Base Year The year that applications for free or reduced-price meal
benefits were distributed, eligibility determinations were
made, and verification was conducted. This is considered
the first year of operation for provisions.
Benefit Issuance Document Link between the eligibility determination and how a meal
is claimed for reimbursement. Must be completed during a
base year.
Child Nutrition Programs Includes the National School Lunch, School Breakfast,
Special Milk Programs, After School Care Snack Program,
and Summer Food Programs.
Daily Edit Checks Ensures the number of eligible children does not exceed
the meal count for the day.
Delayed Implementation
(Provision 2 only)
Enables schools to charge students in reduced price and
paid meal categories in the base year for first claiming
period only.
Direct Certification Process of establishing children's eligibility for benefits by
obtaining documentation directly from the Department of
Economic Security (DES). Households determined eligible
for meal or milk benefits through direct certifications are
not required to submit a free and reduced-price application
to the school; instead they provide the DES notification,
titled Free Meals Programs.
Special Assistance Guidance Manual 44
Appendix
Glossary of Terms
FDPIR (Food Distribution
Program on Indian
Reservations)
Enables families on certain Indian Reservations who meet
Supplemental Nutrition Assistance (SNAP) income
guidelines to receive commodity foods.
Free Meal Meals served under the National School Lunch Program or
School Breakfast Program to a child from a household
eligible for such benefits. Neither the child nor any
household member can be required to work in the school
or in the school's food service to supplement the cost of
the meal.
NSLP (National School Lunch
Program)
Program under which participating schools operating a
nonprofit food service operation receive cash assistance
and donated food assistance.
Non-Pricing Program All enrolled students receive meals at no charge despite
their eligibility status. Meals are claimed for
reimbursement by the students' eligibility status.
Point of Service Meal Counts Meals are counted at that point in the food service
operation where it can be accurately determined that a
reimbursable free, reduced-price or paid meal has been
served to an eligible student.
Pricing Program Charging children eligible for reduced-price and paid meals.
Only an option for Provision 3 in a non extended base year.
Reduced-Price Meal A meal served under the National School Lunch or School
Breakfast Program to a child from a household eligible for
such benefits. The price of this meal MUST be less than the
full price of the meal and no more than 40 cents for lunch
and 30 cents for breakfast. Neither the child nor any
household member can be required to work in the school
or in the school's food service to supplement the cost of
the meal.
SBP (School Breakfast
Program)
Federally assisted meal program operating in schools and
institutions. It provides nutritionally balanced, low-cost, or
free breakfasts to children each school day.
Special Assistance Guidance Manual 45
Appendix
Glossary of Terms
SFA (School Food Authority) Governing body responsible for the administration of one
or more schools and either has the legal authority to
operate School Nutrition Programs in these schools or is
otherwise approved by the Food and Nutrition Service to
operate School Nutrition Programs.
USDA (United States
Department of Agriculture)
Federal agency designated by Congress to administer the
National School Lunch, School Breakfast, Special Milk
Programs, After School Care Snack, and Summer Food
Programs.
Verification Confirmation of eligibility for free and reduced price meals
under the National School Lunch or School Breakfast
Program. Verification must include confirmation of income
eligibility or confirmation that the child is included in a
currently certified Supplemental Nutrition Assistance
(SNAP)/FDPIR/TANF household or CA unit. At State or local
discretion, verification may also include confirmation of
any other information on the application, which is required
as a condition of eligibility.
Special Assistance Guidance Manual 46
Arizona Department of Education
Tom Horne, Superintendent of Public Instruction
The Arizona Department of Education does not discriminate on the basis of race, religion, color, national
origin, sex, disability or age in its programs, activities or in its hiring and employment practices. If you
have questions or grievances related to this policy, please contact the Administrative Services DAS at
(602) 542-3186.